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mPAP/CO斜率和氧气吸收增加了大动脉狭窄的预后价值

Sarah Hoedemakers^1,2,3,4, Nicola Riccardo Pugliese⁵, Jan Stassen^1,2,3

¹Departments of Cardiology (S.H., J.S., M.F., S.M.F., G.C., L.H., J.V.), Jessa Hospital, Hasselt, Belgium.

|February 27, 2024

概括

肺动脉平均压力/心脏输出 (mPAP/CO) 倾斜率是主动脉缩中心血管事件的有价值预测指标,其表现优于肺动脉最大压力. 这一发现有助于对患有这种疾病的患者进行更好的风险分层.

科学领域:

心脏病学
肺高血压
心声检查

背景情况:

最近的指南使用平均肺动脉压力/心脏输出 (mPAP/CO) 斜率来定义运动性肺高血压.
运动期间的静脉血压峰值与大动脉狭窄的不良结果有关.
在主动脉狭窄的mPAP/ CO倾斜的预后意义以前是未知的.

研究的目的:

在患有大动脉狭窄的患者中研究mPAP/CO斜率的预后值.
要确定mPAP/CO倾斜率是否预测该人群中的心血管事件.
为了比较mPAP/CO倾斜的预后效用与最大静脉动脉压.

主要方法:

一项前性队列研究包括143名大动脉面积≤1.5厘米的患者,这些患者接受了心肺运动测试和心声扫描.
对心血管事件,包括死亡,心力衰竭住院,心房动和主动脉置换等,对患者进行了长达1年的随访.
这些发现在141名患者的外部队列中得到了验证.

主要成果:

mPAP/ CO倾斜率 (OR/ SD,2. 01;P=0. 002) 和百分比预测的运动氧气吸收峰值 (OR/ SD,0. 59;P=0. 007) 是心血管事件的独立预测指标.
静脉血压峰值与心血管事件没有独立关联 (每次SD的OR为1.28;P=0.219).
mPAP/ CO 斜率和 Vo2 峰值提供了指数化左心室体积和主动脉面积以外的增量预后值.

结论:

在中度至重度的大动脉狭窄时,mPAP/CO倾斜率和百分比预测的峰值Vo2是心血管事件的独立预测指标.
在这种情况下,静脉血压的峰值不是一个重要的独立预测指标.
将mPAP/CO倾斜度和峰值Vo2与现有参数相结合,可以改善主动脉狭窄的心血管风险分层.

关键词:

大动脉狭窄症心脏输出运动测试高血压,肺部疾病预后情况

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