肺动脉形压力和左心室末端透气压力在炼期间在患有呼吸障碍的患者
Claudia Baratto1, Andrea Faini1,2, Gianluca P Gallone1
1Department of Cardiology, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milan, Italy.
ERJ open research
|September 6, 2023
概括
运动期间的肺动脉压 (PAWP) 是准确的,但对于估计左心室末端透气压 (LVEDP) 不准确. 虽然PAWP和LVEDP在诊断心力衰竭时显示出很好的一致性,但它们偶尔可能会有所不同.
科学领域:
- 心脏病学 心脏病学
- 血液动力学 血液动力学
- 诊断的准确性 诊断的准确性
背景情况:
- 肺动脉压 (PAWP) 被用作左心室 (LV) 末端透气压 (EDP) 的替代品,用于诊断心力衰竭与保留射出分数 (HFpEF) 的诊断.
- 肺部末端透气压 (LVEDP) 是评估肺部填充的黄金标准,而平均PAWP (PAWPM) 更好地反映了肺循环负荷.
研究的目的:
- 为了确定PAWP估计的精度和准确性,在练习过程中对LVEDP进行估计.
- 在HFpEF诊断的背景下,评估PAWP和LVEDP测量之间的一致率.
主要方法:
- 在46名人在休息和运动期间同时进行右心和左心导管.
- 评估线性回归,布兰德-阿尔特曼图,以及在HFpEF的诊断值下LVEDP和PAWP之间的一致率.
主要成果:
- 在运动高峰时,PAWPM和PAWPend-diastolic (PAWPED) 与LVEDP (R20.69,p<0.01) 呈现出相当的相关性,偏差最小,但一致性极大 (±11 mmHg).
- 89%的个体相对于HFpEF的25 mmHg值 (科恩的 κ=0.64) 具有一致的PAWP和LVEDP分类.
- 患有高LVEDP或PAWPM的个体表现出特定的PAWPM相对于心脏输出变化而增加.
结论:
- 在运动期间,PAWP提供了准确但不精确的LVEDP估计.
- 尽管一致率很好,但PAWP和LVEDP测量之间的差异可能会发生,需要在HFpEF诊断中仔细解释.
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