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通过使用侵袭性左心室压力-体积循环,在患有不明原因呼吸障碍的患者中诊断HFpEF

Romy Gessner¹, Anna-Christina Hübner², Stephan Stöbe¹

¹Department of Cardiology, Leipzig University Hospital, Leipzig, Germany; Central German Heart Alliance, Leipzig, Germany.

Journal of cardiac failure

|November 13, 2025

概括

诊断心力衰竭与保存的喷射分数 (HFpEF) 是困难的. 侵入性压力-体积循环在93%的患者中证实了HFpEF,揭示了这种情况的非侵入性诊断得分的局限性.

科学领域:

心脏病学心脏病学
心血管生理学心血管生理学
诊断医学诊断医学诊断医学

背景情况:

通过保留喷射分数 (HFpEF) 诊断心力衰竭存在重大临床挑战.
对HFpEF的非侵入性诊断算法需要对侵入性血液动力学测量进行验证,这是当前的黄金标准.

研究的目的:

通过使用左心室 (LV) 压力-体积 (PVL) 循环,估计患有不明原因的运动性呼吸障碍的evolemic患者中HFpEF的患病率.
为了验证非侵入性诊断算法的性能与侵入性LV PVL测量.

主要方法:

使用右心导管注射和实时连续LVPVL来评估不明原因的运动性呼吸不良和保存的LV喷射分数的患者.
HFpEF是由高的LV填充压力或受损的放松/增加的LV度来定义的.
在HFpEF和非HFpEF组之间比较了H2FPEF和HFA-PEF得分的诊断性能.

主要成果:

93%的被纳入患者 (共28人中有26人) 在入侵性LV PVL的基础上被诊断出HFpEF.
通过增加填充压力 (11名患者) 或在没有增加压力的情况下减轻/硬度受损 (15名患者) 证实了HFpEF.
非侵入性诊断得分显示高特异性,但对HFpEF检测的敏感性不足.

结论:

显著比例的HFpEF患者 (一半) 通过右心导管检查表现出正常的血液动力学,但通过减弱放松或LV度达到HFpEF标准.
需要进一步的研究,以了解这一亚组的临床意义,并加强诊断和治疗策略.

关键词:

HFpEF HFpEF 的意思是什么导电性导管管道的导电性导管.在炼时出现呼吸障碍.压力-体积循环的循环

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