Abnormal pulmonary artery systolic pressure response after exercise in systemic sclerosis patients: A PRISMA-compliant meta-analysis

Background:Pulmonary artery systolic pressure (PASP) is an important parameter for detecting pulmonary arterial hypertension (PAH). The difference between rest PASP and post-exercise PASP (PASP) may play a role in predicting and screening resting PAH. The aim of this study is to analyze PASP in systemic sclerosis (SSc) patients with PAH or non-PAH and suggest a cutoff value of PASP for detection of PAH.Methods:PubMed, Embase, and Web of Science were searched for relevant publications up to July 7, 2018. Characteristics of control, no PAH, exercise-induced PAH (EIPH) and PAH subgroups in SSc patients were extracted. R 3.5.0 with the meta package was used to conduct this meta-analysis.Results:Twelve articles involving 1279 patients were included in this study. The subgroups meta-analysis showed pooled mean PASP in different subgroups: control group (8.6 mmHg, 95% CI: 6.9-10.5), no PAH group (12.2 mmHg, 95% CI: 11.2-13.2), EIPH group (26.0 mmHg, 95% CI: 24.2-27.7) and PAH group (36.2 mmHg, 95% CI: 29.7-42.7).Conclusion:Combining the results of our study with the previous studies, an abnormal increase in PASP after exercise could indicate the development of PAH in SSc patients. In addition, if PASP>29 mmHg, a high suspicion of PAH should be raised.