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Heart:心肺运动试验可用于检测系统性硬化症患者的肺动脉高压

2017-01-07 xing.T MedSci原创

CPET是诊断SSc相关的PAH的一种安全有效的无创检测方法。它对减少不必要的RHC检查特别有益。

肺动脉高压(PAH)是一种生存率较低的毁灭性疾病,并且是系统性硬化症(SSc)患者的一种常见并发症。PAH的明确诊断是通过右心导管(RHC)检查而获得;然而,初步诊断是通过无创性的方法来确定。近日,在心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员评估了用于检测和排除SSc相关的PAH心肺运动试验(CPET)的关键参数的诊断准确性。

在这个多中心研究中,研究人员前瞻性地评估了173例连续就诊的无PAH的SSc患者,但这些患者临床怀疑患有PAH,每个患者都接受了CPET和RHC检查。

研究人员注意到,通过RHC检测确定的48例(27.8%)PAH患者,10例(5.8%)毛细血管后肺动脉高压(PH),并且排除了115例(66.5%)PH患者。研究者还发现CPET参数与肺血流动力学显著相关。VO2峰值、VE/VCO2显示与肺动脉PAH检测管阻力相关性最高。受试者工作特性分析发现用于PAH检测的几个参数具有较高的敏感性和特异性。然而,VO2峰值的诊断准确性最高(当阈值设定在13.8mL/min/kg时,敏感性为87.5%,特异性为74.8%)。在这一队列中,173例患者中的38例患者(22%)VO2峰值>18.7mL/min/kg,并且排除PAH(阴性预测值为1.0)。VE/VCO2比值的最低点>45.5表明阳性预测值为1.0。低肺动脉楔压(<12mmHg)的患者诊断准确率最高。没有研究相关的严重不良事件发生。

由此可见,CPET是诊断SSc相关的PAH的一种安全有效的无创检测方法,它对减少不必要的RHC检查特别有益。

原始出处:

Daniel Dumitrescu,et al. Cardiopulmonary exercise testing for detecting pulmonary arterial hypertension in systemic sclerosis. Heart. 2017. 


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    2017-09-03 aids222
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time=2017-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1925158, encodeId=c1ca1925158fc, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33354, encryptionId=26d633354c9, topicName=动脉高压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Mar 12 09:37:00 CST 2017, time=2017-03-12, status=1, ipAttribution=)]
    2017-01-09 虈亣靌

    学习了,分享了。

    0

  7. 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time=2017-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1925158, encodeId=c1ca1925158fc, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33354, encryptionId=26d633354c9, topicName=动脉高压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Mar 12 09:37:00 CST 2017, time=2017-03-12, status=1, ipAttribution=)]
    2017-01-09 zhaojie88
  8. 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time=2017-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1925158, encodeId=c1ca1925158fc, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33354, encryptionId=26d633354c9, topicName=动脉高压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Mar 12 09:37:00 CST 2017, time=2017-03-12, status=1, ipAttribution=)]
    2017-01-09 slcumt
  9. 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