在患有慢性阻塞性肺病 (COPD) 的患者中评估心脏功能障碍:一个横截面研究
Rehab A Mohammed1,2, Layla A Mohamed3, Eman M Abdelsalam1
1Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EGY.
Cureus
|June 30, 2023
概括
慢性阻塞性肺病 (COPD) 患者心脏异常很常见. 心声学,肺功能测试,动脉血液气体和大脑 natriuretic 水平可以帮助预测COPD患者的心血管功能障碍.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 心血管疾病 (CVD) 在慢性阻塞性肺病 (COPD) 患者中很普遍.
- 慢性肺炎患者的并发性心血管疾病通常未被诊断或未得到充分治疗,原因是指导方针建议的查不足.
- 这项研究调查了在没有心脏病病史的COPD患者的心脏功能和预后指标.
研究的目的:
- 在中度至非常严重的COPD患者中使用心声学来评估心脏功能.
- 评估螺旋计,动脉血液气体 (ABG) 分析,以及脑内尿素 (BNP) 作为心血管功能障碍的预后指标.
- 在这个人群中确定右心室 (RV) 和左心室 (LV) 功能障碍的预测因子.
主要方法:
- 从沙特阿拉伯招募了100名中度至非常严重的COPD患者 (GOLD指南).
- 评估包括心电图 (ECG),胸部X射线,BNP,肺功能测试,ABG分析和横心电图.
- 采用多重线性回归分析来确定VR和LV功能障碍的预测因素.
主要成果:
- 肺高血压 (PH) 在28%的患者中被发现;25%的患者有异常的三状环状平面缩外流 (TAPSE).
- 左心室喷射分数 (LVEF) 和应变异常在20%,右心室应变异常在17%,和部分面积变化 (FAC) 在9%.
- 年龄,糖尿病,高脂血症,低氧血症,高头,强迫生命能力 (FVC) 和BNP水平是心脏功能障碍的重要预测因素.
结论:
- 心脏异常常见于中度至非常严重的COPD患者.
- 心声图是评估COPD患者心脏功能的一个有价值的工具,即使没有心脏病史.
- 肺功能,ABG和BNP提供了关于COPD心脏功能的额外预测信息.
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