特发性肺动脉高压中肺动脉容量与死亡率的关系
Relationship of pulmonary arterial capacitance and mortality in idiopathic pulmonary arterial hypertension.
作者信息
Mahapatra Srijoy, Nishimura Rick A, Sorajja Paul, Cha Stephen, McGoon Michael D
机构信息
Division of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
J Am Coll Cardiol. 2006 Feb 21;47(4):799-803. doi: 10.1016/j.jacc.2005.09.054. Epub 2006 Jan 26.
OBJECTIVES
The purpose of this study was to determine if pulmonary vascular capacitance predicts survival in patients with idiopathic pulmonary arterial hypertension (IPAH).
BACKGROUND
The prognosis of patients with IPAH is difficult to predict, despite knowledge of clinical and hemodynamic parameters previously identified as predictors.
METHODS
We proposed a capacitance index of stroke volume divided by pulmonary pulse pressure (SV/PP) and prospectively gathered data on IPAH patients who underwent a right heart catheterization. SV/PP was analyzed as a predictor of mortality after adjusting for other modifiers of risk.
RESULTS
During 4-year follow-up of 104 patients, 21 patients died. When compared with conventional markers, SV/PP was the strongest univariate predictor of mortality (hazard ratio 17.0 per ml.mm Hg(-1) decrease, 95% confidence interval 13.0 to 22.0; p < 0.0001). In successive bivariate analysis, SV/PP was the only predictor of mortality. In quartile analysis, the lowest SV/PP quartile had a 4-year mortality of 61%; the highest SV/PP had no deaths.
CONCLUSIONS
The capacitance index (SV/PP) is a strong independent predictor of mortality in patients with IPAH.
目的
本研究旨在确定肺血管容量是否可预测特发性肺动脉高压（IPAH）患者的生存率。
背景
尽管已知先前确定的临床和血流动力学参数可作为预测指标，但IPAH患者的预后仍难以预测。
方法
我们提出了一个每搏量除以肺脉压的容量指数（SV/PP），并前瞻性收集了接受右心导管检查的IPAH患者的数据。在校正其他风险修正因素后，分析SV/PP作为死亡率的预测指标。
结果
在对104例患者进行的4年随访中，有21例患者死亡。与传统指标相比，SV/PP是死亡率最强的单变量预测指标（每降低1 ml·mmHg-1，风险比为17.0，95%置信区间为13.0至22.0；p<0.0001）。在连续的双变量分析中，SV/PP是唯一的死亡率预测指标。在四分位数分析中，SV/PP最低的四分位数组4年死亡率为61%；SV/PP最高的四分位数组无死亡病例。
结论
容量指数（SV/PP）是IPAH患者死亡率的一个强有力的独立预测指标。
Zotero 插件