通过心声图的高肺高血压风险缩短了多细胞真血症的生存期
Alexander J Gazda1, Di Pan1, Katie Erdos2
1Division of Pulmonary and Critical Care, Department of Medicine, Weill Cornell Medical College, New York, NY.
肺高血压 (PH) 显著影响多细胞血症真 (PV) 患者的生存率. 在心声回声学上,高PH风险与三倍增加的死亡风险有关,需要有针对性的查.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 肺部病理学 肺部病理学
背景情况:
- 肺高血压 (PH) 是骨髓增殖性瘤 (MPNs) 的常见并发症,影响高达50%的患者.
- 多细胞血病 (PV) 患者表现出与PH重叠的症状,但PH对PV结果的影响尚不清楚.
研究的目的:
- 为了研究基于心声学 (ECHO) 的PH风险对大量单中心PV患者队列的生存的影响.
- 为了确定PH患者PH发育的风险因素.
主要方法:
- 对134名PV患者的分析,在637名患者中至少有一名ECHO患者.
- 在ECHO上使用三回喷射速度进行PH风险评估.
- 卡普兰-梅尔和考克斯的比例危险模型来评估生存率.
- 后勤回归用于识别PH风险因素.
主要成果:
- 与轻度 (3.7年) 或正常风险相比,高PH风险与显著缩短的生存期 (中位数为1.7年) 相关.
- 高PH风险独立增加了三倍以上的死亡风险.
- 年龄和PV诊断的持续时间是发展PH的重要风险因素.
结论:
- 基于心声图的PH风险是PV患者生存的关键决定因素.
- 建议在70岁以上的PV患者或PV持续时间超过8年的PV患者进行PH查.
- 需要进一步研究侵入性血液动力学和生物标志物,以指导PV中PH的治疗干预措施.
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