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AB0633 Association of Decrease Diffusing Lung Capacity with Progression Pulmonary Alterations by HRCT in Patients with Systemic Sclerosis over A Five-Year Period
  1. O.B. Ovsyannikova,
  2. O. Koneva
  1. Department of Vascular Pathology, Nasonova Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

Background Functional lung tests play a one of the key role in assessment of SS pulmonary manifestations. As many as 90% of pts will have interstitial abnormalities on HRCT and 40-75% will have changes in pulmonary function tests (PFTs).

Objectives to evaluate association of pulmonary function with differences interstitial abnormalities on high-resolution computed tomography (HRCT) in patients with systemic sclerosis over a five-year period.

Methods It was a longitudinal study involving 83 pts with SSc (mean age was 46,2±13,4; 69% were limited; 95% were female). They were included from cohort of 150 pts. all fulfilling of ACR criteria of SSc and were evaluated in our department between 2006 and 2012yy (the mean duration of follow up was 58,9±12,0 months). The criteria of selected was consequently 5 years of follow up by PFTs and HRCT of lung. The pts were divided into two groups using of clinically significant DLCO reduction (at ≥10%) group 1 (n=31) and other without reduction - group 2 (n=52). Approximately five years after the first evaluation, the pts underwent spirometry and measurement of DLCO, chest HRCT, echocardiography. All pts received glucocorticoids, cyclophosphamide 42% (group 1) and 27% (group 2) (p>0,05).

Results the main characteristics were not significantly different between groups 1 and 2 (age 40.7±13.6 vs 37±13,3; duration of disease from the first non-Raynaud's syndrome was 5,8±4,9 vs 8,4±7,6, presents of diffuse 39% vs 27% accordingly) (p>0,05). SPAP remained within the normal range in both groups during 5 yrs (27.5±3.9 vs 31.5±8.9 and 29.4±7.0 vs 30.1±8.0 accordingly (p>0,05)). The presents of a-Scl-70 was prevalence in group 1 than in group 2 (69% vs 46% (p<0,05) RO 2,61 (0,99-6,84)).

At the beginning DLCO was higher in the group 1, but after the 5 years follow up it became lower than in group 2. The comparison of PFTs and dates HRCT showed that clinically significant reduction of DLCO associated with worse of lung by HRCT. The number of pts with honeycombing in this group increased 18%, that significantly higher than in group without reduction of DLCO.

Conclusions Chances of developing of honeycombing and worse of lung by HRCT higher in pts with clinically significant reduction of DLCO, instead of normal dates FVC. DLCO is the most significant marker of poor prognosis.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5169

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