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Int J Cardiol:右心室收缩期与舒张期持续时间比值为PAH成人的预后因素

2019-05-08 xing.T 网络

由此可见,在诊断和IPAH随访时SD比率具有预后价值。应考虑进一步评估当前PAH危险分层参数。

收缩期与舒张期(SD)持续时间比率反映了肺动脉高压(PAH)中的整体RV的功能,但其在非先天性PAH成人中的应用数据十分有限。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员评估了特发性PAH(IPAH)超声心动图的SD比率,以确定其对肺血管扩张剂治疗的反应及其在诊断及随访时的预后价值。

在2005年至2018年期间,研究人员在所在中心确定了接受超声心动图、血液动力学和运动评估的IPAH患者。在诊断和随访时调整心率的SD比率。

在诊断的98例患者中,超声心动图上平均SD比率为1.03±0.37,在中位间隔为9.0个月的随访后下降至0.85±0.25,p<0.001。诊断时的SD比率与RV基底直径(r=0.24,p=0.04)和6MWD(r=0.23,p=0.04)相关性较弱。随访时,接受联合治疗组与单药治疗肺血管扩张剂治疗组相比,其平均SD比值较低(分别为71±25 vs. 92±22%,p<0.001)。中位随访4.8年后,3例患者进行移植,23例患者死亡。诊断和随访时的SD比值可预测死亡/移植风险增加(HR为2.41(1.09-5.29),p=0.03; HR为5.02(1.27-19.77),p=0.02),在具有6MWD(HR为2.18(1.06-4.08))、WHO功能类(HR为2.33(1.04-5.21))和TAPSE(HR为2.36(1.07-5.19))的双变量模型中,诊断时仍具有其预测价值,所有p<0.05。

由此可见,在诊断和IPAH随访时SD比率具有预后价值。应考虑进一步评估当前PAH危险分层参数。 

原始出处:

C.McCabe,et al.Right ventricular systolic to diastolic duration ratio: A novel predictor of outcome in adult idiopathic pulmonary arterial hypertension.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.05.019

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    2019-05-10 hb2010ye
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    2019-05-10 zhwj
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