运动期间的心脏输出:热稀释与直接性交相比
Matthew T Siuba1, James Lane2, Vaidehi Mendpara3
1Department of Pulmonary and Critical Care Medicine Integrated Hospital Care Institute, Cleveland Clinic Cleveland OH USA.
热稀释心脏输出 (CO) 与休息和运动期间的直接Fick CO (dfCO) 不同,具有广泛的协议限制. 然而,这种方法可能不会显著改变运动肺高血压的诊断.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗器械 医疗器械
背景情况:
- 准确的心脏输出 (CO) 测量对于诊断运动性肺高血压 (PH) 是至关重要的.
- 将热稀释CO与直接Fick CO (dfCO) 进行比较对于临床准确性至关重要.
- 运动PH诊断需要在休息和运动期间可靠的CO评估.
研究的目的:
- 为了比较热稀释CO的性能与黄金标准dfCO的性能.
- 为了评估休息和运动期间的CO测量.
- 评估二氧化碳测量差异对PH分类的影响.
主要方法:
- 对302名接受入侵性心肺运动测试的患者进行前性队列研究.
- 一般化添加模型用于预测CO在各种炼阶段.
- 进行了布兰德-阿尔特曼分析,以评估热稀释和dfCO之间的一致性.
主要成果:
- 热稀释CO与dfCO有显著差异,在静止状态下低估,在最大运动时高估.
- 两种二氧化碳测量方法之间观察到很大程度上的一致性,特别是在高峰运动时.
- 尽管存在差异,但运动PH,毛囊前PH和毛囊后PH的分类没有发生显著变化.
结论:
- 热稀释和dfCO之间存在显著的差异和广泛的协议限制.
- 在运动期间进行连续的热稀释测量可能会减轻对PH诊断的临床影响.
- 对CO测量差异的临床影响需要在运动PH评估中仔细考虑.
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