Pulmonary arterial hypertension associated with connective tissue diseases (CTD-PAH): Recent and advanced data

Autoimmun Rev. 2024 Apr;23(4):103506. doi: 10.1016/j.autrev.2023.103506. Epub 2023 Dec 21.

Abstract

Pulmonary arterial hypertension (PAH), corresponding to group 1 of pulmonary hypertension classification, is a rare disease with a major prognostic impact on morbidity and mortality. PAH can be either primary in idiopathic and heritable forms or secondary to other conditions including connective tissue diseases (CTD-PAH). Within CTD-PAH, the leading cause of PAH is systemic sclerosis (SSc) in Western countries, whereas systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) are predominantly associated with PAH in Asia. Although many advances have been made during the last two decades regarding classification, definition early screening and risk stratification and therapeutic aspects with initial combination treatment, the specificities of CTD-PAH are not yet clear. In this manuscript, we review recent literature data regarding the updated definition and classification of PAH, pathogenesis, epidemiology, detection, prognosis and treatment of CTD-PAH.

Keywords: Connective tissue disease; Early detection; Epidemiology; Immunosuppressive treatment; PAH targeted therapies; Prognosis; Pulmonary arterial hypertension.

Publication types

  • Review

MeSH terms

  • Connective Tissue Diseases* / complications
  • Connective Tissue Diseases* / diagnosis
  • Connective Tissue Diseases* / epidemiology
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / epidemiology
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / therapy
  • Prognosis
  • Pulmonary Arterial Hypertension* / diagnosis
  • Pulmonary Arterial Hypertension* / epidemiology
  • Pulmonary Arterial Hypertension* / etiology
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / epidemiology