在TAPSE/sPAP比率改善风险评估在肺动脉高血压
Roberto Badagliacca1, Khodr Tello2, Michele D'Alto3
1Department of Cardiovascular and Respiratory Sciences-Sapienza University of Rome, Italy (R.B., D.F., G.M., A.M., S.P., T.R., C.D.V.).
使用三环形平面的缩外流与缩肺动脉压力 (TAPSE/sPAP) 比率来评估右心室肺动脉合,可以提高肺动脉高血压 (PAH) 患者的风险预测. 这一比率提高了生存预测,特别是在中等风险组.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 右心室 (RV) 功能对于肺动脉高血压 (PAH) 的结果至关重要.
- 通过TAPSE/sPAP评估的RV-PA合可能会改进风险分层.
研究的目的:
- 评估TAPSE/sPAP比率是否改善了针对性治疗的PAH患者的生存预测风险评估.
主要方法:
- 意大利11个中心有望招募677名PAH患者.
- 收集基线和随访临床,心声学和右心脏导管数据.
- 欧洲心脏病学会/欧洲呼吸学会和REVEAL 2.0风险分数与TAPSE/sPAP比率的比较,在德国队列中得到验证.
主要成果:
- 在长期随访中,TAPSE/sPAP比率增加与低风险状态相关 (OR为ESC/ERS的1.78,OR为REVEAL的1.43).
- TAPSE/sPAP比率增强了两种风险评分的预后信息,特别是在中等风险层 (ESC/ERS的截止值为0.5,0.35,0.30 mm/mmHg;REVEAL 2.0的0.35 mm/mmHg).
- 这些发现在德国追溯验证队列中得到证实.
结论:
- TAPSE/sPAP比率改善了PAH患者的风险分层.
- 这一比率为现有的风险评分增加了预后价值,除了在非常低或非常高的疾病阶段.
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