肺毛细血管压是肺毛细血管后高血压的可靠指标吗?
Emre Aslanger1, Dursun Akaslan2, Halil Ataş2
1Department of Cardiology, Başakşehir Pine and Sakura City Hospital, Istanbul, Turkey.
一种新的测量方法,左心室跨壁压差 (∆ PTM),可以改善肺高血压 (PH) 的诊断. 这种方法在PH患者中更好地区分左侧心脏病,而不仅仅是肺毛细血管压力.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 血液动力学 血液动力学
背景情况:
- 目前的肺高血压 (PH) 准则使用肺毛细血管压 (PCWP) >15 mm Hg来检测毛细血管后PH.
- 由于PH的复杂血液动力学,PCWP的诊断准确性可能受到限制.
研究的目的:
- 为了调查左心室的脑外压力差异 (∆ PTM) 是否有助于诊断毛囊后PH.
- 评估∆ PTM与PH分类和患者死亡率的相关性.
主要方法:
- 对961名经过心脏导管治疗的PH患者进行了回顾性观察研究.
- ∆ PTM计算为PCWP减去右心房压力.
- 分析不同PH组的∆PTM值,以及与PCWP和死亡率的相关性.
主要成果:
- 与其他PH组相比,II组PH (左心病) 患者的∆ PTM (12.6 ± 6.6 mm Hg) 显着更高,尽管PCWP值重叠.
- ∆PTM切割值为7mmHg,当PCWP>15mmHg (AUC0.825) 时,有效地识别出左心脏病.
- 较高的∆PTM与显著增加的5年死亡率有关.
结论:
- ∆ PTM提供了额外的辨别能力,用于识别毛囊后PH.
- 这种新的方法可能会增强对PH病理生理学的理解.
- ∆ PTM可能有助于识别可能受益于向治疗的PH亚群.
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