New York Heart Association class and pulmonary artery pressure as prognostic factors of interstitial lung disease survival

OBJECTIVE: The aim of this study was to evaluate New York Heart Associ-ation (NYHA) class and systolic pulmonary ar-tery pressure (sPAP) as survival predictors in major interstitial lung diseases (ILD) including idiopathic pulmonary fibrosis (IPF), non-spe-cific interstitial pneumonia (NSIP) and hyper-sensitivity pneumonitis (HP) and in other ILD like granulomatosis with polyangiitis (GPA). PATIENTS AND METHODS: We analyzed survival, NYHA class, sPAP, and Octreoscan uptake index (UI) in 104 ILD patients (59 IPF, 19 NSIP, 10 HP and 16 GPA; median age 60.5 years) all referred to a single centre.RESULTS: Median survival was 68 months, with 1-and 2-year survival of 91% and 78%, re-spectively. Survival was lower among IPF and NSIP vs. HP and GPA patients (p=0.01). NY -HA class 3-4 was more frequent among IPF (76.3%) vs. NSIP patients (31.6%; p<0.001). HP and GPA had NYHA class 1-2. NYHA class was negatively associated with survival (class 1=90.3 months vs. class 3=18.3 months and class 4=5.1 months; p=0.001). sPAP was >55 mmHg in 76.3% of patients with IPF and 35-55 mmHg in 63.2% of patients with NSIP. Patients with HP and GPA had sPAP < 55 mmHg. Among patients with IPF, NYHA and sPAP were neg-atively associated with survival (p<0.01) both showed a parallel trend. High-resolution com-puted tomography and survival were worse among IPF and NSIP vs. HP and GPA patients (p<0.001). Octreoscan UI was <10, 10-12, and >12 in IPF, NSIP, HP and GPA, respectively. Oc-treoscan UI was negatively associated with survival (p=0.002).CONCLUSIONS: NYHA class and sPAP are comparable ILD survival predictors. NYHA class is correlated with worse prognosis for IPF and NSIP vs. HP and GPA patients.

Automated summary

The aim of this study was to evaluate the predictive value of New York Heart Association (NYHA) class and systolic pulmonary artery pressure (sPAP) in major interstitial lung diseases (ILD) including idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), hypersensitivity pneumonitis (HP) and other ILD like granulomatosis with polyangiitis (GPA). Analysis of 104 ILD patients showed that NYHA class and sPAP were negatively associated with survival, indicating worse prognosis for IPF and NSIP compared to HP and GPA patients.