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Pulmonary Vasospasm in Systemic Sclerosis: Noninvasive Techniques for Detection:

机译：系统性硬化中的肺血管痉挛：非侵入性检测技术：

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In a subgroup of patients with systemic sclerosis (SSc), vasospasm affecting the pulmonary circulation may contribute to worsening respiratory symptoms, including dyspnea. Noninvasive assessment of pulmonary blood flow (PBF), utilizing inert-gas rebreathing (IGR) and dual-energy computed-tomography pulmonary angiography (DE-CTPA), may be useful for identifying pulmonary vasospasm. Thirty-one participants (22 SSc patients and 9 healthy volunteers) underwent PBF assessment with IGR and DE-CTPA at baseline and after provocation with a cold-air inhalation challenge (CACh). Before the study investigations, participants were assigned to subgroups: group A included SSc patients who reported increased breathlessness after exposure to cold air (n = 11), group B included SSc patients without cold-air sensitivity (n = 11), and group C patients included the healthy volunteers. Median change in PBF from baseline was compared between groups A, B, and C after CACh. Compared with groups B and C, in group A there was a significant decline in median PBF from baseline at 10 minutes (?10%; range: ?52.2% to 4.0%; P 0.01), 20 minutes (?17.4%; ?27.9% to 0.0%; P 0.01), and 30 minutes (?8.5%; ?34.4% to 2.0%; P 0.01) after CACh. There was no significant difference in median PBF change between groups B or C at any time point and no change in pulmonary perfusion on DE-CTPA. Reduction in pulmonary blood flow following CACh suggests that pulmonary vasospasm may be present in a subgroup of patients with SSc and may contribute to worsening dyspnea on exposure to cold.
机译：在患有系统性硬化症（SSc）的患者亚组中，影响肺循环的血管痉挛可能导致呼吸困难（包括呼吸困难）恶化。利用惰性气体呼吸（IGR）和双能计算机断层扫描肺血管造影（DE-CTPA）进行的肺动脉血流（PBF）的无创评估可能对识别肺血管痉挛有用。 31名参与者（22名SSc患者和9名健康志愿者）在基线时以及在受到冷空气吸入攻击（CACh）激发后，接受了IGR和DE-CTPA的PBF评估。在研究调查之前，将参与者分为亚组：A组包括在暴露于冷空气后呼吸急促增加的SSc患者（n = 11），B组包括对冷空气不敏感的SSc患者（n = 11），C组患者包括健康志愿者。在CACh后比较A，B和C组的PBF相对于基线的中位数变化。与B组和C组相比，A组在10分钟（≥10％;范围：≥52.2％至4.0％; P <0.01），20分钟（≥17.4％;≥10％;基线时）从基线显着下降。 CACh后27.9％至0.0％; P <0.01）和30分钟（？8.5％;? 34.4％至2.0％; P <0.01）。在任何时间点，B组或C组之间的PBF中位数变化均无显着差异，DE-CTPA上的肺灌注也无变化。 CACh后肺血流量减少表明，SSc患者亚组中可能存在肺血管痉挛，并可能在暴露于寒冷时加剧呼吸困难。

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