右心室功能恢复评估与压力心声和肺栓塞后心肺运动测试:一个试点前性多中心研究
Chinthaka Bhagya Samaranayake1,2, John Upham2,3, Khoa Tran2,4
1National Pulmonary Hypertension Service, Royal Brompton Hospital, London, UK c.samaranayake@uq.net.au.
BMJ open respiratory research
|July 25, 2023
概括
几乎三分之一的肺栓塞 (PE) 幸存者显示右心室 (RV) 运动适应能力受损. 通过应力心声和心肺运动测试 (CPET) 早期检测RV-PA脱对于管理长期并发症至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 运动生理学 运动生理学
背景情况:
- 有限的数据存在于急性中期和高风险肺栓塞 (PE) 后的右心室 (RV) 运动适应.
- 了解PE幸存者的VR功能恢复和运动参数对于长期管理至关重要.
研究的目的:
- 为了评估症状负担,运动期间的VR功能恢复,以及急性中期和高风险PE幸存者的心肺运动参数.
- 为了确定RV适应能力受损和长期并发症的预测因素.
主要方法:
- 在澳大利亚和英国的4个地点招募24名急性后中期/高风险PE患者 (平均年龄55岁).
- 在3个月的随访中,利用了应激心声学,心肺运动测试 (CPET) 和通风 perfusion (VQ) 扫描.
- 评估RV功能,运动能力 (氧气消耗峰值),症状负担 (PEmb-QoL,emPHasis-10),以及RV-肺动脉 (PA) 脱.
主要成果:
- 75%的患者经历了峰值氧气消耗和工作量减少,持续高症状负担.
- 29.2%的患者表现出RV系统功能障碍和RV-PA脱,与增加的呼吸系统低效率和氧气脱有关.
- 在VQ扫描中,RV-PA脱与持续的输液缺陷相关,表明慢性血栓栓塞性肺血管疾病.
结论:
- 运动期间RV适应能力受损影响了近三分之一的PE幸存者.
- 结合应激心电回声学和CPET帮助表型患者在PE后持续症状.
- 这种方法有助于及时检测长期并发症,如慢性血栓栓塞性肺血管疾病.
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