右心室-肺动脉合用于急性肺栓塞的预后
Mads Dam Lyhne1,2, Behnood Bikdeli3,4,5,6, David Jiménez7,8,9
1Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
European heart journal. Acute cardiovascular care
|October 23, 2024
概括
下三环状平面缩外流 (TAPSE) 与肺动脉缩压 (PASP) 的比率表明急性肺栓塞 (PE) 患者的死亡风险增加. 这个比率可以改善风险分层,特别是对于中等风险的个人.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 急性肺栓塞 (PE) 显著影响右心室 (RV) 功能和肺血液动力学.
- 心声谱提供了一种评估RV功能和肺压力的方法,TAPSE/PASP比率是关键指标.
研究的目的:
- 评估TAPSE/PASP比率在诊断急性PE的患者中预测30天死亡率的预后价值.
- 确定TAPSE/PASP比率是否提高了风险分层,超出了欧洲心脏病学会 (ESC) 现有的指南.
主要方法:
- 来自Registro Informatizado Enfermedad TromboEmbolica登记处的一大队列 (4478名患者) 的分析.
- 利用多变量后勤回归来评估TAPSE/PASP比率与不同ESC风险类别的30天死亡率之间的关联.
- 与RV/LV比率和ESC风险层相比,评估了该比率重新分类风险的能力.
主要成果:
- 降低TAPSE/PASP比率与30天死亡率相反相关 (调整后OR为每0.1个下降1.32).
- 特定的TAPSE/PASP比率切点与低,中低,中高风险PE群体的死亡率显著增加有关.
- 该TAPSE/PASP比率显示,对死亡率预测的净重新分类有显著的改善.
结论:
- TAPSE/PASP比率是急性PE的有价值的预后标志物,与增加的死亡率相关.
- 这种心声回声比率可以帮助临床医生做出决策,特别是对于中等风险的PE患者,这些患者通常使用当前工具的歧视能力有限.
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