Screening is important to determine whether patients with systemic sclerosis (SSc) have pulmonary hypertension because earlier pulmonary hypertension treatment can improve survival in these patients. Although decreased transfer factor of the lung for carbon monoxide (TLCO) is currently considered the best pulmonary function test for screening for pulmonary hypertension in SSc, small series have suggested that partitioning TLCO into membrane conductance (diffusing capacity) for carbon monoxide (DMCO) and alveolar capillary blood volume (VC) through combined measurement of TLCO and transfer factor of the lung for nitric oxide (TLNO) is more effective to identify pulmonary hypertension in SSc patients compared with TLCO alone. Here, the objective was to determine whether combined TLCO–TLNO partitioned with recently refined equations could more accurately detect pulmonary hypertension than TLCO alone in SSc. For that purpose, 572 unselected consecutive SSc patients were retrospectively recruited in seven French centres. Pulmonary hypertension was diagnosed with right heart catheterisation in 58 patients. TLCO, TLNO and VC were all lower in SSc patients with pulmonary hypertension than in SSc patients without pulmonary hypertension. The area under the receiver operating characteristic curve for the presence of pulmonary hypertension was equivalent for TLCO (0.82, 95% CI 0.79–0.85) and TLNO (0.80, 95% CI 0.76–0.83), but lower for VC (0.75, 95% CI 0.71–0.78) and DMCO (0.66, 95% CI 0.62–0.70). Compared with TLCO alone, combined TLCO–TLNO does not add capability to detect pulmonary hypertension in unselected SSc patients. Compared with T LCO alone, combined T LCO–T LNO measurement does not improve detection of PH in unselected SSc patients http://ow.ly/ITHO30eldMk

中文翻译：

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一氧化碳和一氧化氮肺转移的联合测量不能改善系统性硬化症肺动脉高压的识别

筛查对于确定系统性硬化症 (SSc) 患者是否患有肺动脉高压很重要，因为早期肺动脉高压治疗可以提高这些患者的生存率。虽然降低一氧化碳的肺转移因子 (TLCO) 目前被认为是筛查 SSc 肺动脉高压的最佳肺功能测试，但小系列建议将 TLCO 划分为一氧化碳 (DMCO) 的膜电导（扩散能力）和与单独使用 TLCO 相比，通过联合测量 TLCO 和肺一氧化氮转移因子 (TLNO) 的肺泡毛细血管血容量 (VC) 可以更有效地识别 SSc 患者的肺动脉高压。这里，目的是确定在 SSc 中，与单独使用 TLCO 相比，使用最近改进的方程划分的组合 TLCO-TLNO 是否可以更准确地检测肺动脉高压。为此，在七个法国中心回顾性招募了 572 名未选择的连续 SSc 患者。58 名患者因右心导管插入术被诊断为肺动脉高压。合并肺动脉高压的 SSc 患者的 TLCO、TLNO 和 VC 均低于无肺动脉高压的 SSc 患者。TLCO (0.82, 95% CI 0.79–0.85) 和 TLNO (0.80, 95% CI 0.76–0.83) 存在肺动脉高压的受试者工作特征曲线下面积相等，但 VC (0.75, 95%) 较低CI 0.71–0.78) 和 DMCO (0.66, 95% CI 0.62–0.70)。与单独的 TLCO 相比，TLCO-TLNO 组合不会增加检测未选择 SSc 患者肺动脉高压的能力。与单独的 T LCO 相比，联合 T LCO-T LNO 测量不能改善未选择的 SSc 患者的 PH 检测 http://ow.ly/ITHO30eldMk