运动诱导的心电图 肺动脉高血压的变化
Maya Kailas1, Aimee M Layton2, Meredith Pesce3
1Division of Pediatric Cardiology, Mount Sinai Kravis Children's Hospital, New York, New York.
The American journal of cardiology
|October 11, 2023
概括
在心肺运动测试 (CPET) 期间的心电图 (ECG) 变化可以预测肺动脉高血压 (PAH) 患者的不良结果. 这些ST-T波变化表明肺动脉平均压力较高和潜在的临床恶化.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 运动生理学 运动生理学
背景情况:
- 心肺运动测试 (CPET) 评估肺动脉高血压 (PAH) 的功能能力.
- 在CPET期间,心电图 (ECG) 监测运动引起的缺血或心律失常.
- 对于PAH临床恶化的ECG变化的预测价值需要进一步调查.
研究的目的:
- 为了确定CPET期间的ECG变化是否预测儿科和年轻成人PAH患者的不良结果.
- 研究运动诱导的ST-T波变化与PAH中的血液动力学参数之间的关联.
- 为了确定心电图变化作为PAH临床恶化的潜在早期指标.
主要方法:
- 从155名PAH患者 (7-40岁) 的临床,血液动力学和CPET数据的回顾性分析.
- 在CPET期间,分析了ECG以检测ST压缩和T波逆转.
- 副作用分为严重 (死亡/肺移植) 或中度 (药物升级/住院).
主要成果:
- 41%的患者在中位数为5年的随访期间至少经历过一次不良结果.
- 25%的患者在运动期间表现出显著的ST-T波变化.
- ST-T波变化与死亡或肺移植的可能性增加了20%,并与平均肺动脉压 (mPAP) 的升高相关.
结论:
- 运动诱导的ST-T波变化是PAH患者不良结果的显著预测因素.
- 这些心电图发现与较高的mPAP相关,这表明它们反映了疾病的严重程度.
- 在CPET过程中对心电图进行监测,可以作为一种早期预警系统,用于发现PAH临床恶化.
相关概念视频
Electrocardiogram
2.4K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.4K
Exercise Stress Test
242
Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
242
Pulmonary Hypertension: Classification and Pathogenesis
194
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
194
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
176
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
176
Pulmonary Embolism I: Introduction
7
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
7
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
177
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
177


