Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group
Identifieur interne : 002476 ( PascalFrancis/Checkpoint ); précédent : 002475; suivant : 002477Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group
Auteurs : Otylia Kowal-Bielecka [Pologne, France, Allemagne, Royaume-Uni, Italie, Australie, États-Unis, Suisse] ; Jerome Avouac ; David Pittrow ; Doerte Huscher ; Frank Behrens ; Christopher P. Denton ; Ivan Foeldvari ; Marc Humbert ; Marco Matucci-Cerinic ; Peter Nash ; Christian F. Opitz ; Lewis J. Rubin ; James R. Seibold ; Vibeke Strand ; Daniel E. Furst ; Oliver DistlerSource :
- Journal of rheumatology [ 0315-162X ] ; 2010.
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Abstract
Objective. To assess the validation status of echocardiography with continuous Doppler (echo-Doppler) as an outcome measure in pulmonary arterial hypertension associated with systemic sclerosis (PAH-SSc). Methods. Structured literature review on full-text English articles was performed using the PubMed and Cochrane databases. Assessment of validation of echo-Doppler was based on the OMERACT filter criteria with the domains truth (face, content, construct, and criterion validity), discrimination, and feasibility. Results. Out of 35 studies eligible for analysis, only 5 included well defined PAH-SSc subgroups (World Health Organization criteria). Echo was considered as having face validity based on expert opinion and high number of studies using echo for evaluation of patients with SSc. Echo was considered partially validated with respect to criterion validity based on significant correlations between echo measures and right-heart catheterization in patients with SSc at risk of PAH/PH. However, echo was found to lack specificity (lack of content validity), since measurements of echo pulmonary pressure may be influenced by left-heart disease and interstitial lung disease. Data from general populations of patients with scleroderma indicate that evaluation of pulmonary artery pressure by echo might not be available in all PAH-SSc patients because of technical factors. No studies enabling evaluation of the discriminant capacity over time and treatment of echo in PAH-SSc could be identified. Conclusion. Further studies are needed to fully validate echo-Doppler as an outcome measure in PAH-SSc. These studies would include cross-sectional analysis of baseline measures and longitudinal data of placebo and verum groups in randomized controlled trials of patients with PAH-SSc.
Affiliations:
- Allemagne, Australie, France, Italie, Pologne, Royaume-Uni, Suisse, États-Unis
- Angleterre, Berlin, Californie, District de Darmstadt, District de Dresde, Grand Londres, Hesse (Land), Michigan, Saxe (Land), Île-de-France
- Berlin, Dresde, Francfort-sur-le-Main, Londres, Orsay, Paris
- Université Paris-Sud
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group</title><author><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Rheumatology and Internal Medicine, Medical University of Bialystok</s1><s2>Bialystok</s2><s3>POL</s3></inist:fA14><country>Pologne</country><wicri:noRegion>Bialystok</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Rheumatology Department A, RDU</s1><s2>Paris</s2><s3>FRA</s3></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Institute for Clinical Pharmacology, Medical Faculty, Technical University</s1><s2>Dresden</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Division of Rheumatology/ZAFES, J.W. 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Furst</name></author><author><name sortKey="Distler, Oliver" sort="Distler, Oliver" uniqKey="Distler O" first="Oliver" last="Distler">Oliver Distler</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">10-0086413</idno><date when="2010">2010</date><idno type="stanalyst">PASCAL 10-0086413 INIST</idno><idno type="RBID">Pascal:10-0086413</idno><idno type="wicri:Area/PascalFrancis/Corpus">002888</idno><idno type="wicri:Area/PascalFrancis/Curation">003698</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002476</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">002476</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group</title><author><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Rheumatology and Internal Medicine, Medical University of Bialystok</s1><s2>Bialystok</s2><s3>POL</s3></inist:fA14><country>Pologne</country><wicri:noRegion>Bialystok</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Rheumatology Department A, RDU</s1><s2>Paris</s2><s3>FRA</s3></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Institute for Clinical Pharmacology, Medical Faculty, Technical University</s1><s2>Dresden</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Division of Rheumatology/ZAFES, J.W. Goethe University</s1><s2>Frankfurt</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>German Rheumatism Research Centre</s1><s2>Berlin</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Centre for Rheumatology, Royal Free and University College, Medical School</s1><s2>London</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Pediatric Rheumatology Clinic, General Hospital Eilbek</s1><s2>Eilbek</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><wicri:noRegion>Eilbek</wicri:noRegion><wicri:noRegion>General Hospital Eilbek</wicri:noRegion><wicri:noRegion>Eilbek</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="08"><s1>Service de Pneumologie et Reanimation Respiratoire, Centre des Maladies Vasculaires Pulmonaires, Hopital Antoine-Beclere, Université Paris-Sud</s1><s2>Clamart</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Clamart</wicri:noRegion><wicri:noRegion>Université Paris-Sud</wicri:noRegion><placeName><settlement type="city">Orsay</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="university">Université Paris-Sud</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Medicine, Division of Rheumatology, Denothe Center, University of Florence</s1><s2>Florence</s2><s3>ITA</s3></inist:fA14><country>Italie</country><wicri:noRegion>Florence</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Rheumatology Research Unit, Cotton Tree, Sunshine Coast</s1><s2>Queensland</s2><s3>AUS</s3></inist:fA14><country>Australie</country><wicri:noRegion>Queensland</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Klinik für Innere Medizin, DRK-Kliniken Berlin Köpenick</s1><s2>Berlin</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="12"><s1>Division of Pulmonary and Critical Care Medicine, University of California, San Diego School of Medicine</s1><s2>La Jolla, California</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="13"><s1>University of Michigan Scleroderma Program</s1><s2>Ann Arbor, Michigan</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="14"><s1>Division of Immunology and Rheumatology, Stanford University School of Medicine</s1><s2>Portola Valley, California</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="15"><s1>Division of Rheumatology, Department of Medicine, David Geffen School at UCLA</s1><s2>Los Angeles, California</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Department of Rheumatology, University Hospital Zurich</s1><s2>Zurich</s2><s3>CHE</s3></inist:fA14><country>Suisse</country><wicri:noRegion>Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Avouac, Jerome" sort="Avouac, Jerome" uniqKey="Avouac J" first="Jerome" last="Avouac">Jerome Avouac</name></author><author><name sortKey="Pittrow, David" sort="Pittrow, David" uniqKey="Pittrow D" first="David" last="Pittrow">David Pittrow</name></author><author><name sortKey="Huscher, Doerte" sort="Huscher, Doerte" uniqKey="Huscher D" first="Doerte" last="Huscher">Doerte Huscher</name></author><author><name sortKey="Behrens, Frank" sort="Behrens, Frank" uniqKey="Behrens F" first="Frank" last="Behrens">Frank Behrens</name></author><author><name sortKey="Denton, Christopher P" sort="Denton, Christopher P" uniqKey="Denton C" first="Christopher P." last="Denton">Christopher P. Denton</name></author><author><name sortKey="Foeldvari, Ivan" sort="Foeldvari, Ivan" uniqKey="Foeldvari I" first="Ivan" last="Foeldvari">Ivan Foeldvari</name></author><author><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name></author><author><name sortKey="Matucci Cerinic, Marco" sort="Matucci Cerinic, Marco" uniqKey="Matucci Cerinic M" first="Marco" last="Matucci-Cerinic">Marco Matucci-Cerinic</name></author><author><name sortKey="Nash, Peter" sort="Nash, Peter" uniqKey="Nash P" first="Peter" last="Nash">Peter Nash</name></author><author><name sortKey="Opitz, Christian F" sort="Opitz, Christian F" uniqKey="Opitz C" first="Christian F." last="Opitz">Christian F. Opitz</name></author><author><name sortKey="Rubin, Lewis J" sort="Rubin, Lewis J" uniqKey="Rubin L" first="Lewis J." last="Rubin">Lewis J. Rubin</name></author><author><name sortKey="Seibold, James R" sort="Seibold, James R" uniqKey="Seibold J" first="James R." last="Seibold">James R. Seibold</name></author><author><name sortKey="Strand, Vibeke" sort="Strand, Vibeke" uniqKey="Strand V" first="Vibeke" last="Strand">Vibeke Strand</name></author><author><name sortKey="Furst, Daniel E" sort="Furst, Daniel E" uniqKey="Furst D" first="Daniel E." last="Furst">Daniel E. Furst</name></author><author><name sortKey="Distler, Oliver" sort="Distler, Oliver" uniqKey="Distler O" first="Oliver" last="Distler">Oliver Distler</name></author></analytic><series><title level="j" type="main">Journal of rheumatology</title><title level="j" type="abbreviated">J. rheumatol.</title><idno type="ISSN">0315-162X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of rheumatology</title><title level="j" type="abbreviated">J. rheumatol.</title><idno type="ISSN">0315-162X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Artery</term><term>Clinical trial</term><term>Disseminated</term><term>Doppler ultrasound study</term><term>Echocardiography</term><term>Hypertension</term><term>Prognosis</term><term>Pulmonary hypertension</term><term>Rheumatology</term><term>Scleroderma</term><term>Sclerosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Echocardiographie</term><term>Pronostic</term><term>Sclérodermie</term><term>Hypertension artérielle pulmonaire</term><term>Artère</term><term>Hypertension artérielle</term><term>Dopplérométrie</term><term>Disséminé</term><term>Sclérose</term><term>Essai clinique</term><term>Rhumatologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. To assess the validation status of echocardiography with continuous Doppler (echo-Doppler) as an outcome measure in pulmonary arterial hypertension associated with systemic sclerosis (PAH-SSc). Methods. Structured literature review on full-text English articles was performed using the PubMed and Cochrane databases. Assessment of validation of echo-Doppler was based on the OMERACT filter criteria with the domains truth (face, content, construct, and criterion validity), discrimination, and feasibility. Results. Out of 35 studies eligible for analysis, only 5 included well defined PAH-SSc subgroups (World Health Organization criteria). Echo was considered as having face validity based on expert opinion and high number of studies using echo for evaluation of patients with SSc. Echo was considered partially validated with respect to criterion validity based on significant correlations between echo measures and right-heart catheterization in patients with SSc at risk of PAH/PH. However, echo was found to lack specificity (lack of content validity), since measurements of echo pulmonary pressure may be influenced by left-heart disease and interstitial lung disease. Data from general populations of patients with scleroderma indicate that evaluation of pulmonary artery pressure by echo might not be available in all PAH-SSc patients because of technical factors. No studies enabling evaluation of the discriminant capacity over time and treatment of echo in PAH-SSc could be identified. Conclusion. Further studies are needed to fully validate echo-Doppler as an outcome measure in PAH-SSc. These studies would include cross-sectional analysis of baseline measures and longitudinal data of placebo and verum groups in randomized controlled trials of patients with PAH-SSc.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0315-162X</s0></fA01><fA02 i1="01"><s0>JRHUA9</s0></fA02><fA03 i2="1"><s0>J. rheumatol.</s0></fA03><fA05><s2>37</s2></fA05><fA06><s2>1</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group</s1></fA08><fA11 i1="01" i2="1"><s1>KOWAL-BIELECKA (Otylia)</s1></fA11><fA11 i1="02" i2="1"><s1>AVOUAC (Jerome)</s1></fA11><fA11 i1="03" i2="1"><s1>PITTROW (David)</s1></fA11><fA11 i1="04" i2="1"><s1>HUSCHER (Doerte)</s1></fA11><fA11 i1="05" i2="1"><s1>BEHRENS (Frank)</s1></fA11><fA11 i1="06" i2="1"><s1>DENTON (Christopher P.)</s1></fA11><fA11 i1="07" i2="1"><s1>FOELDVARI (Ivan)</s1></fA11><fA11 i1="08" i2="1"><s1>HUMBERT (Marc)</s1></fA11><fA11 i1="09" i2="1"><s1>MATUCCI-CERINIC (Marco)</s1></fA11><fA11 i1="10" i2="1"><s1>NASH (Peter)</s1></fA11><fA11 i1="11" i2="1"><s1>OPITZ (Christian F.)</s1></fA11><fA11 i1="12" i2="1"><s1>RUBIN (Lewis J.)</s1></fA11><fA11 i1="13" i2="1"><s1>SEIBOLD (James R.)</s1></fA11><fA11 i1="14" i2="1"><s1>STRAND (Vibeke)</s1></fA11><fA11 i1="15" i2="1"><s1>FURST (Daniel E.)</s1></fA11><fA11 i1="16" i2="1"><s1>DISTLER (Oliver)</s1></fA11><fA14 i1="01"><s1>Department of Rheumatology and Internal Medicine, Medical University of Bialystok</s1><s2>Bialystok</s2><s3>POL</s3></fA14><fA14 i1="02"><s1>Rheumatology Department A, RDU</s1><s2>Paris</s2><s3>FRA</s3></fA14><fA14 i1="03"><s1>Institute for Clinical Pharmacology, Medical Faculty, Technical University</s1><s2>Dresden</s2><s3>DEU</s3></fA14><fA14 i1="04"><s1>Division of Rheumatology/ZAFES, J.W. Goethe University</s1><s2>Frankfurt</s2><s3>DEU</s3></fA14><fA14 i1="05"><s1>German Rheumatism Research Centre</s1><s2>Berlin</s2><s3>DEU</s3></fA14><fA14 i1="06"><s1>Centre for Rheumatology, Royal Free and University College, Medical School</s1><s2>London</s2><s3>GBR</s3></fA14><fA14 i1="07"><s1>Pediatric Rheumatology Clinic, General Hospital Eilbek</s1><s2>Eilbek</s2><s3>DEU</s3></fA14><fA14 i1="08"><s1>Service de Pneumologie et Reanimation Respiratoire, Centre des Maladies Vasculaires Pulmonaires, Hopital Antoine-Beclere, Université Paris-Sud</s1><s2>Clamart</s2><s3>FRA</s3></fA14><fA14 i1="09"><s1>Department of Medicine, Division of Rheumatology, Denothe Center, University of Florence</s1><s2>Florence</s2><s3>ITA</s3></fA14><fA14 i1="10"><s1>Rheumatology Research Unit, Cotton Tree, Sunshine Coast</s1><s2>Queensland</s2><s3>AUS</s3></fA14><fA14 i1="11"><s1>Klinik für Innere Medizin, DRK-Kliniken Berlin Köpenick</s1><s2>Berlin</s2><s3>DEU</s3></fA14><fA14 i1="12"><s1>Division of Pulmonary and Critical Care Medicine, University of California, San Diego School of Medicine</s1><s2>La Jolla, California</s2><s3>USA</s3></fA14><fA14 i1="13"><s1>University of Michigan Scleroderma Program</s1><s2>Ann Arbor, Michigan</s2><s3>USA</s3></fA14><fA14 i1="14"><s1>Division of Immunology and Rheumatology, Stanford University School of Medicine</s1><s2>Portola Valley, California</s2><s3>USA</s3></fA14><fA14 i1="15"><s1>Division of Rheumatology, Department of Medicine, David Geffen School at UCLA</s1><s2>Los Angeles, California</s2><s3>USA</s3></fA14><fA14 i1="16"><s1>Department of Rheumatology, University Hospital Zurich</s1><s2>Zurich</s2><s3>CHE</s3></fA14><fA17 i1="01" i2="1"><s1>EPOSS Group</s1><s3>INC</s3></fA17><fA20><s1>105-115</s1></fA20><fA21><s1>2010</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>16024</s2><s5>354000189240770170</s5></fA43><fA44><s0>0000</s0><s1>© 2010 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>51 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>10-0086413</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of rheumatology</s0></fA64><fA66 i1="01"><s0>CAN</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective. To assess the validation status of echocardiography with continuous Doppler (echo-Doppler) as an outcome measure in pulmonary arterial hypertension associated with systemic sclerosis (PAH-SSc). Methods. Structured literature review on full-text English articles was performed using the PubMed and Cochrane databases. Assessment of validation of echo-Doppler was based on the OMERACT filter criteria with the domains truth (face, content, construct, and criterion validity), discrimination, and feasibility. Results. Out of 35 studies eligible for analysis, only 5 included well defined PAH-SSc subgroups (World Health Organization criteria). Echo was considered as having face validity based on expert opinion and high number of studies using echo for evaluation of patients with SSc. Echo was considered partially validated with respect to criterion validity based on significant correlations between echo measures and right-heart catheterization in patients with SSc at risk of PAH/PH. However, echo was found to lack specificity (lack of content validity), since measurements of echo pulmonary pressure may be influenced by left-heart disease and interstitial lung disease. Data from general populations of patients with scleroderma indicate that evaluation of pulmonary artery pressure by echo might not be available in all PAH-SSc patients because of technical factors. No studies enabling evaluation of the discriminant capacity over time and treatment of echo in PAH-SSc could be identified. Conclusion. Further studies are needed to fully validate echo-Doppler as an outcome measure in PAH-SSc. These studies would include cross-sectional analysis of baseline measures and longitudinal data of placebo and verum groups in randomized controlled trials of patients with PAH-SSc.</s0></fC01><fC02 i1="01" i2="X"><s0>002B15</s0></fC02><fC02 i1="02" i2="X"><s0>002B24C01</s0></fC02><fC02 i1="03" i2="X"><s0>002B07</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Echocardiographie</s0><s5>07</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Echocardiography</s0><s5>07</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Ecocardiografía</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pronostic</s0><s5>08</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Prognosis</s0><s5>08</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Pronóstico</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Sclérodermie</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Scleroderma</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Esclerodermia</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Hypertension artérielle pulmonaire</s0><s5>13</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Pulmonary hypertension</s0><s5>13</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Hipertensión arterial pulmonar</s0><s5>13</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Artère</s0><s5>14</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Artery</s0><s5>14</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Arteria</s0><s5>14</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Hypertension artérielle</s0><s5>15</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Hypertension</s0><s5>15</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Hipertensión arterial</s0><s5>15</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Dopplérométrie</s0><s5>16</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Doppler ultrasound study</s0><s5>16</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Dopplerometría</s0><s5>16</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Disséminé</s0><s5>17</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Disseminated</s0><s5>17</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Diseminado</s0><s5>17</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Sclérose</s0><s5>18</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Sclerosis</s0><s5>18</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Esclerosis</s0><s5>18</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Essai clinique</s0><s5>19</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Clinical trial</s0><s5>19</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Ensayo clínico</s0><s5>19</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Rhumatologie</s0><s5>20</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Rheumatology</s0><s5>20</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Reumatología</s0><s5>20</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Exploration ultrason</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Sonography</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Exploración ultrasonido</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Maladie autoimmune</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Autoimmune disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Enfermedad autoinmune</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie de système</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Systemic disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad sistémica</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie de la peau</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Skin disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Piel patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du tissu conjonctif</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Connective tissue disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Tejido conjuntivo patología</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>42</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Pathologie de l'appareil respiratoire</s0><s5>43</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Respiratory disease</s0><s5>43</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Aparato respiratorio patología</s0><s5>43</s5></fC07><fC07 i1="08" i2="X" l="FRE"><s0>Immunopathologie</s0><s5>44</s5></fC07><fC07 i1="08" i2="X" l="ENG"><s0>Immunopathology</s0><s5>44</s5></fC07><fC07 i1="08" i2="X" l="SPA"><s0>Inmunopatología</s0><s5>44</s5></fC07><fN21><s1>053</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Italie</li><li>Pologne</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Berlin</li><li>Californie</li><li>District de Darmstadt</li><li>District de Dresde</li><li>Grand Londres</li><li>Hesse (Land)</li><li>Michigan</li><li>Saxe (Land)</li><li>Île-de-France</li></region><settlement><li>Berlin</li><li>Dresde</li><li>Francfort-sur-le-Main</li><li>Londres</li><li>Orsay</li><li>Paris</li></settlement><orgName><li>Université Paris-Sud</li></orgName></list><tree><noCountry><name sortKey="Avouac, Jerome" sort="Avouac, Jerome" uniqKey="Avouac J" first="Jerome" last="Avouac">Jerome Avouac</name><name sortKey="Behrens, Frank" sort="Behrens, Frank" uniqKey="Behrens F" first="Frank" last="Behrens">Frank Behrens</name><name sortKey="Denton, Christopher P" sort="Denton, Christopher P" uniqKey="Denton C" first="Christopher P." last="Denton">Christopher P. Denton</name><name sortKey="Distler, Oliver" sort="Distler, Oliver" uniqKey="Distler O" first="Oliver" last="Distler">Oliver Distler</name><name sortKey="Foeldvari, Ivan" sort="Foeldvari, Ivan" uniqKey="Foeldvari I" first="Ivan" last="Foeldvari">Ivan Foeldvari</name><name sortKey="Furst, Daniel E" sort="Furst, Daniel E" uniqKey="Furst D" first="Daniel E." last="Furst">Daniel E. Furst</name><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name><name sortKey="Huscher, Doerte" sort="Huscher, Doerte" uniqKey="Huscher D" first="Doerte" last="Huscher">Doerte Huscher</name><name sortKey="Matucci Cerinic, Marco" sort="Matucci Cerinic, Marco" uniqKey="Matucci Cerinic M" first="Marco" last="Matucci-Cerinic">Marco Matucci-Cerinic</name><name sortKey="Nash, Peter" sort="Nash, Peter" uniqKey="Nash P" first="Peter" last="Nash">Peter Nash</name><name sortKey="Opitz, Christian F" sort="Opitz, Christian F" uniqKey="Opitz C" first="Christian F." last="Opitz">Christian F. Opitz</name><name sortKey="Pittrow, David" sort="Pittrow, David" uniqKey="Pittrow D" first="David" last="Pittrow">David Pittrow</name><name sortKey="Rubin, Lewis J" sort="Rubin, Lewis J" uniqKey="Rubin L" first="Lewis J." last="Rubin">Lewis J. Rubin</name><name sortKey="Seibold, James R" sort="Seibold, James R" uniqKey="Seibold J" first="James R." last="Seibold">James R. Seibold</name><name sortKey="Strand, Vibeke" sort="Strand, Vibeke" uniqKey="Strand V" first="Vibeke" last="Strand">Vibeke Strand</name></noCountry><country name="Pologne"><noRegion><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></region><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></country><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></region><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></region></country><country name="Italie"><noRegion><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></noRegion></country><country name="États-Unis"><region name="Californie"><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></region><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></country><country name="Suisse"><noRegion><name sortKey="Kowal Bielecka, Otylia" sort="Kowal Bielecka, Otylia" uniqKey="Kowal Bielecka O" first="Otylia" last="Kowal-Bielecka">Otylia Kowal-Bielecka</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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