左心室功能障碍在与系统性硬化症相关的肺高血压中的作用
Justin K Lui1, Matthew Cozzolino2, Morgan Winburn2
1Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA.
左心室 (LV) 功能障碍在与系统性硬化相关的肺高血压 (SSc-PH) 中很常见. 使用LV全球纵向菌株 (GLS) 识别LV功能障碍可以帮助评估SSc-PH患者的死亡风险.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
背景情况:
- 系统性硬化症 (SSc) 与显著的发病率和死亡率有关,特别是来自肺高血压 (PH).
- 系统性硬化症相关的肺高血压 (SSc-PH) 是异质的,左侧心脏病的作用尚不清楚.
- 左侧心脏病,特别是左心室 (LV) 功能障碍,是SSc-PH的研究不足的因素.
研究的目的:
- 为了确定SSc患者进行右心导管治疗的LV功能障碍的患病率.
- 调查共存的LV功能障碍和SSc-PH对所有原因死亡率的影响.
- 评估LV全球纵向应变 (GLS) 在SSc-PH中识别LV功能障碍和风险分层方面的有用性.
主要方法:
- 对165名SSc患者进行了回顾性观察性研究.
- 带有斑点追踪的心声学,以评估LV全球纵向应变 (GLS).
- LV功能障碍定义为GLS> -18%;SSc-PH定义为肺动脉平均压力> 20 mmHg.
主要成果:
- 在74.2%的SSc-PH患者和51.2%的SSc患者没有SSc-PH中,LV功能障碍是普遍存在的.
- 患有SSc-PH和LV功能障碍的患者的中位生存期为67.9个月.
- 在对共变量进行调整后,SSc-PH与LV功能障碍显著增加了全因死亡风险 (HR 12.64).
结论:
- 在SSc-PH患者中,LV功能障碍非常常见.
- LV GLS是检测SSc-PH中的LV功能障碍的一个有价值的工具.
- LV GLS有助于评估SSc-PH患者因任何原因死亡的风险.
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