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International Journal of Rheumatology
Volume 2016, Article ID 4564531, 7 pages
Research Article

SAPHIRE: Stress and Pulmonary Hypertension in Rheumatoid Evaluation—A Prevalence Study

1John Hunter Hospital, University of Newcastle, Callaghan, NSW 2308, Australia
2Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
3Autoimmune Resource and Research Centre, New Lambton Heights, NSW 2305, Australia
4Pathology North, New Lambton Heights, NSW 2305, Australia

Received 16 November 2015; Revised 2 March 2016; Accepted 16 March 2016

Academic Editor: Ruben Burgos-Vargas

Copyright © 2016 G. E. M. Reeves et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Pulmonary artery hypertension (PAH) is a disorder of elevated resistance in the pulmonary arterial vessels, reflected by elevation of measured pulmonary artery pressure (PAP), and presenting with breathlessness and, if untreated, progressing to right heart failure and death. The heightened prevalence of PAH in populations with underlying systemic autoimmune conditions, particularly scleroderma and its variants, is well recognised, consistent with the proposed autoimmune contribution to PAH pathogenesis, along with disordered thrombotic, inflammatory, and mitogenic factors. Rheumatoid arthritis (RA) is one of a group of systemic autoimmune conditions featuring inflammatory symmetrical erosive polyarthropathy as its hallmark. This study explored the prevalence of PAH in a population of unselected individuals with RA, using exercise echocardiography (EchoCG). The high prevalence of EchoCG-derived elevation of PAP (EDEPP) in this population (14%) suggests that, like other autoimmune conditions, RA may be a risk factor for PAH. Patients with RA may therefore represent another population for whom PAH screening with noninvasive tools such as EchoCG may be justified.