Source: International Congress 2016 – Pulmonary hypertension and pulmonary embolism: from the bench to the bedside
Disease area: Pulmonary vascular diseases

Abstract

IntroductionDecreased nitric oxide (NO) availability is implicated in the pathogenesis of pulmonary arterial hypertension (PAH). Prior studies found low fractional exhaled NO (FeNO) in idiopathic PAH (IPAH) and scleroderma-related PAH (SSc-PAH) patients. Comparison among different forms of PH has not been reported.AimsCompare FeNO levels among different PH groups using NIOX® (Aerocrine) and assess correlations with disease activity.MethodsConsecutive patients with PAH WHO groups 1 and 4 (chronic thromboembolic PH, CTEPH) seen at Tufts PH clinic underwent FeNO measurements. All measurements were performed at the same visit. T tests and regression analyses were performed as appropriate.ResultsPatients were middle aged, with mild to moderate functional impairment

Table 1

	IPAH N=8	SSc-PAH N=8	APAH N=3	CTEPH N=7
Age, Mean (SD)	58 (13)	63 (7)	61 (7)	62 (14)
NYHA FC I, II, III, IV, N (%)	0 (0), 7 (87.5), 1 (12.5), 0 (0)	1 (12.5), 4 (50), 3 (37.5), 0 (0)	0 (0), 3 (100), 0 (0), 0 (0)	1 (16.7), 5 (83.3), 0 (0), 0 (0)
6MWD, meters, mean (SD)	491 (89)	382 (146)	359 (179)	470 (52)

 

All were on PAH medications. FeNO levels were significantly lower in SSc-PAH vs. IPAH and CTEPH patients



FeNO correlated inversely with the distance walked in 6 min in the CTEPH group (r=0.8)ConclusionsFeNO levels vary between different types of PH and are particularly low in SSc-PAH. In CTEPH, FeNO levels correlate with functional capacity. FeNO may be a useful diagnostic or disease monitoring tool.


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Hala El Chami (Boston, United States of America), Hala El Chami, Cheryl Fortier, Rosemary Tsacoyianis, Kari Roberts, Nicholas Hill, Ioana Preston. Fractional exhaled nitric oxide in pulmonary hypertension. Eur Respir J 2016; 48: Suppl. 60, 2492

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