急性肺栓塞后长期右室功能障碍的患病率:系统性审查和元分析
Dingyi Wang1,2,3,4, Guohui Fan1,2,3,4, Xiaomeng Zhang1,2,3,5,6
1National Clinical Research Center for Respiratory Diseases, Beijing, P.R. China.
EClinicalMedicine
|August 28, 2023
概括
持续的右心室功能障碍 (RVD) 在急性肺栓塞 (PE) 后很常见. 这一系统性审查强调了RVD的患病率和功能障碍,表明治疗策略可能会影响长期结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医疗成像医学成像
背景情况:
- 右心室功能障碍 (RVD) 是急性肺栓塞 (PE) 中不良结果的已知预测因素.
- 有限的数据存在于长期,对右心室 (RV) 形态,压力和功能在PE后的综合评估.
- 进一步了解RV功能对于指导PE患者的长期治疗至关重要.
研究的目的:
- 系统地审查和分析急性肺栓塞后的长期右心室参数.
- 评估各种随访时间点的RVD和功能障碍的患病率.
- 探索治疗策略对长期RVD的影响.
主要方法:
- 在Pubmed,EMBASE和WebofScience (1998-2023) 的系统文献搜索.
- 包括 >3个月的随访期的研究,通过心声学或CTPA进行VR评估.
- 对结构,功能和临床参数进行了随机效应元分析.
主要成果:
- 分析了33项研究 (3920名患者);1年RVD患病率为34%.
- 聚合1年的TAPSE:21.80毫米,RV/LV比:0.64,PASP:27.33毫米Hg. 这就是为什么.
- 1年的NYHA III-IV: 6%,6-MWD: 462.98 m. 血栓溶解显示了较低的RVD患病率,但没有统计学意义.
结论:
- 持续的RVD和功能障碍在急性PE后的长期非常普遍.
- 研究设计和RVD定义的异质性可能会限制结论.
- 治疗策略,包括血栓溶解,可能会影响长期RVD患病率.
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