作为心力衰竭的次要肺高血压的非侵入性标志物,左心房喷射分数作为肺高血压的非侵入性标志物
1Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
概括
活性左心房喷射分数 (LAEF) 在预测心力衰竭 (HF) 继发的肺高血压 (PH) 患者的预后结果方面表现有希望. 虽然不优于现有指标,但LAEF有助于评估这种复杂的患者群体的疾病严重程度和分层风险.
科学领域:
- 心脏病学 心脏病学
- 肺高血压研究 肺高血压研究
- 心脏成像 - - 心脏成像
背景情况:
- 由于左心衰竭 (HF) 的二次性肺高血压 (PH) 呈现出复杂的病理生理学和不良预后.
- 左心房 (LA) 功能对疾病进展至关重要,但其预测价值尚未得到充分研究.
- 现有的PH二次HF的预测指标需要进一步改进.
研究的目的:
- 评估左心室 (LA) 度量的预测能力,以对HF二次的PH患者.
- 将LA指标的预后意义与已建立的预测指标进行比较.
- 探索活跃的LA射出分数 (LAEF) 在风险分层中的作用.
主要方法:
- 追溯分析了174名心脏磁共振 (CMR) 影像检测的PH二次到HF的患者.
- 综合终点定义为全因死亡,心肺移植或LVAD植入.
- 使用卡普兰-梅尔曲线和考克斯回归的生存分析,对临床变量和LVEF进行调整.
主要成果:
- 活跃的LAEF与肺动脉压和运动能力相关 (无氧值和峰值VO2的VO2).
- 活跃的LAEF显示了与心声学和CMR变量可比的预后性能.
- 经过调整后,活动LAEF独立预测不良事件 (C统计:0.784).
- 在HF中,低活性LAEF (≤8.6%) 显著增加了复合终点风险 (7.05倍).
结论:
- 活跃的LAEF是评估疾病严重程度和预后的有价值指标,用于二次到高频率的PH中的PH.
- 虽然在统计学上并不优于当前的指标,但积极的LAEF值得考虑.
- 将活跃的LAEF与HF亚型相结合,可以改善风险分层,以更好地管理患者.
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