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Pulmonary arterial hypertension (PAH) is a severe complication of systemic lupus erythematosus (SLE), and SLE-PAH is the most common connective tissue disease (CTD)-associated PAH in Chinese patients.1 The prognosis of SLE-PAH is poor, with 3-year survival rates varying from 45% to 88%.2 3 Due to the complexity and heterogeneity of the underlying disease, it is necessary to further differentiate among SLE-PAH patterns to better understand the disease and optimise its management.
Between 2011 and 2016, a derivation cohort (Shanghai Ren Ji Hospital, n=108) and a validation cohort (Guangdong General Hospital, n=87) of patients with SLE-PAH from two medical centres were included. Patients with SLE-PAH were diagnosed based on right heart catheterisation or echocardiography (peak tricuspid regurgitation velocity >3.4 m/s), and those with left heart disease, pulmonary thrombosis and lung diseases were excluded.4 Based on the baseline clinical manifestations and laboratory findings at the time of the diagnosis of PAH, two distinct clusters were identified and validated by multiple correspondence analysis and k-means clustering. …
FS and YL contributed equally.
Handling editor Josef S Smolen
Contributors All authors took part in drafting and revising the article, and all authors approved the final version to be published. XZ and SY had full access to all the data in the study and take responsibility for the integrity and accuracy of the data. Study design: XZ and SY. Acquisition of data: FS, YL, WW and LG. Analysis and interpretation of data: FS, YL and WW.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests SY has received research funding from the National Key Research and Development Program of China. FS has received research funding from Ren Ji Hospital South Campus, School of Medicine, Shanghai Jiao Tong University. Other coauthors have nothing to disclose.
Patient consent Not required.
Ethics approval The ethical approval was waived for this study due to its retrospective design.
Provenance and peer review Not commissioned; externally peer reviewed.