左心室扩张性功能障碍对系统性硬化症相关的间歇性肺部疾病的生存和呼吸困难的贡献
Jessica L Fairley1, Dylan Hansen2, Andrew Burns1
1J.L. Fairley, MBBS, A. Burns, PhD, D. Prior, PhD, K. Morrisroe, PhD, M. Nikpour, PhD, L.J. Ross, PhD, The University of Melbourne, and St. Vincent's Hospital Melbourne.
The Journal of rheumatology
|January 15, 2024
概括
左心室扩张功能障碍 (LVDD) 影响26%的系统性硬化症 (SSc) 相关的间歇性肺病 (ILD) 患者. 在这个人群中,LVDD与增加的死亡率和严重呼吸障碍有关.
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) 是一种自身免疫性疾病,可以影响多个器官,包括肺和心脏.
- 间歇性肺病 (ILD) 是SSc的常见并发症,导致显著的发病率和死亡率.
- 左心室扩张功能障碍 (LVDD) 是对心脏放松和填充能力的损害,其在SSc-ILD中的患病率和影响尚不清楚.
研究的目的:
- 为了确定SSc-ILD患者中LVDD的患病率.
- 在这个队列中调查LVDD的临床相关性和SSc特定关联.
- 评估LVDD对SSc-ILD患者呼吸不良和生存的影响.
主要方法:
- 分析了一组102名澳大利亚结核病队列研究参与者的队列,这些参与者具有明确的SSc和放射性ILD.
- 用2016年美国心声学会/欧洲心血管成像协会指南评估透气功能.
- 后勤回归和生存分析 (Kaplan-Meier,Cox回归) 用于评估与临床特征,呼吸障碍和死亡率的关联.
主要成果:
- 26%的参与者有LVDD;19%的参与者有不确定的,55%的参与者有正常的透气功能.
- 慢性肺炎与增加的死亡率 (HR2.4,P=0.05) 和严重的呼吸障碍 (Borg尺度OR2.6,P=0.05;世卫组织II类+OR4.2,P=0.08) 相关.
- 传统的风险因素包括年龄,高血压,缺血性心脏病,近端肌肉缩和多病症与LVDD有关.
结论:
- 在SSc-ILD中,LVDD主要与传统的心血管风险因素有关,而不是SSc特定的表现.
- 在SSc-ILD中,LVDD是一个显著的发现,与更糟糕的呼吸障碍和减少生存率相关.
- 这些发现突显了评估SSc-ILD患者的透气功能的重要性.
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