在临床怀疑肺高血压的受试者中,内皮功能与肺压相关
Michele Correale1, Lucia Tricarico2, Francesco Chirivì2
1Cardiothoracic Department, Ospedali Riuniti University Hospital, Foggia, Italy.
内皮功能,通过流媒扩张 (FMD) 非侵入性测量,与肺高血压 (PH) 血液动力学相关. 恶化的口病,特别是高峰三回速度 (TRV) 的病例,预示了疑似PH患者的肺动脉压力 (PAP) 和抵抗力 (PVR) 的增加.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 血管生物学 血管生物学
背景情况:
- 肺高血压 (PH) 具有异常的肺循环血液动力学特征.
- 评估内皮功能可能为PH病理生理学提供见解.
- 评估内皮功能的非侵入性方法可以补充传统的血液动力学评估.
研究的目的:
- 为了研究内皮功能之间的相关性,通过手臂动脉流媒扩张 (FMD) 非侵入性评估,以及疑似PH的患者的血液动力学参数.
- 确定口病是否可以预测肺动脉压升高 (PAP) 和肺血管阻力 (PVR).
主要方法:
- 连续95名怀疑PH的门诊患者被纳入.
- 使用流媒扩张 (FMD) 评估了内皮功能.
- 血液动力学参数,包括肺动脉压 (PAP) 和肺血管阻力 (PVR),通过右侧心脏导管测量.
主要成果:
- 关节性肺动脉压 (sPAP) 与口病的值有显著的反相关性 (r = -0.29,p = 0.016).
- 多变量回归确认的口病在调整临床因素后仍然与sPAP有显著的相关性 (B = -47,p = 0.02).
- 结合受损的口病和高峰三回速度 (TRV) 的结合预测了逐渐增加的sPAP,平均PAP和PVR (趋势p<0.001).
结论:
- 在疑似PH的患者中,非侵入性评估内皮功能 (FMD) 与sPAP相反相关.
- 关节炎,特别是与峰值TRV相结合时,可以作为PAP和PVR升高的非侵入性预测因子.
- 这些发现表明,口病可以成为PH血液动力学的非侵入性评估中的一个有价值的工具.
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