慢性阻塞性肺病患者进行肺移植评估的心声和肺高血压
Moustafa Younis1, Nada Al-Antary2, Rami Dalbah3
1Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, Florida, United States.
The American journal of the medical sciences
|November 15, 2023
概括
心声图显示高特异性但低灵敏性诊断肺高血压 (PH) 在晚期慢性阻塞性肺病 (COPD). 它的准确性提高了排除严重的COPD-PH,与肺部膨胀相反相关.
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:
- 晚期慢性阻塞性肺病 (COPD) 中的肺高血压 (PH) 尚未得到充分研究.
- 心声学在诊断COPD患者的PH中的作用,特别是那些被评估为肺移植的患者,需要进一步调查.
研究的目的:
- 为了比较心声回声学对PH的诊断性能与严重COPD患者的右心脏导管 (RHC) 的诊断性能.
- 在这个人群中评估影响心声回声学准确性的因素.
主要方法:
- 一项单中心研究包括111名重症慢性肺炎患者接受RHC肺移植评估.
- PH和严重PH是根据RHC标准定义的;心声回声学概率遵循ESC指南.
- 统计分析包括总结和单变量分析.
主要成果:
- 74%的患者患有COPD-PH. 心声图显示,对COPD-PH的敏感度为43%,特异性为83%.
- 对于严重的COPD-PH,敏感度为67%,特异性为75%.
- 超声心电图和RHC之间的整体一致性为53%. 更高的TLC降低了一致性,而更高的DLCO增加了一致性.
结论:
- 心声学表现出高特异性,但在晚期COPD中诊断PH的敏感性有限.
- 它的实用性在排除严重的COPD-PH时更大.
- 肺部高通胀 (较高的TLC) 会对诊断一致性产生负面影响.
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