通过mPAP/CO斜率在初级额头肌吐中运动肺高血压
Sebastiaan Dhont1,2, Jan Stassen3, Lieven Herbots2,3
1Department of Cardiology, Ziekenhuis Oost-Limburg, Synaps Park 1, 3600 Genk, Belgium.
European heart journal. Cardiovascular Imaging
|November 17, 2023
概括
肺动脉平均压力对心脏输出 (mPAP/CO) 倾斜率有效地识别了在初级额叶回患者中运动诱导的肺高血压. 这种斜率提供了优越的预后价值,与单次静脉肺动脉压力 (sPAP) 测量和峰值VO2相比.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 运动诱导的肺高血压 (PH) 是通过心脏输出 (mPAP/CO) 的平均肺动脉压的定义,斜率>3 mmHg/L/min.
- 这种情况具有重要的诊断和预后影响.
研究的目的:
- 为了研究mPAP/CO斜率的预后价值,在有显著的初级额头骨吐 (MR) 和保存的喷射分数的患者中.
- 评估mPAP/CO斜率在没有症状或有不一致症状的患者中的实用性.
主要方法:
- 128名初级MR患者接受了运动心电图和心肺检测.
- 临床结局被定义为关干预,新发性心房动,心血管住院和全因死亡率的复合.
主要成果:
- mPAP/CO斜率与峰值VO2相关 (r = -0.52,P < 0.001),不同于峰值静脉肺动脉压力 (sPAP) (r = -0.06,P = 0.584).
- 37%的患者的mPAP/CO斜率大于3mmHg/L/min,与减少无事件生存时间相关 (HR,4.9;P<0.001).
- mPAP/CO斜率与sPAP之间的不一致表明,高斜率和正常sPAP的患者比正常斜率和高sPAP的患者有更糟糕的结果.
结论:
- 通过mPAP/CO斜率识别的运动PH与初级MR的运动能力降低和不良事件增加有关.
- mPAP/CO斜率提供了比单独sPAP或峰值VO2更大的预后信息.
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