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因间质性肺疾病转诊至肺移植科患者的左心室功能障碍

Left ventricular dysfunction in patients with interstitial lung diseases referred for lung transplantation.

作者信息

Jastrzebski D, Nowak J, Ziora D, Wojarski J, Czyzewski D, Kozielski J, Polonski L, Zembala M

机构信息

Department of Lung Diseases and Tuberculosis, Silesian School of Medicine, Zabrze, Poland.

出版信息

J Physiol Pharmacol. 2007 Nov;58 Suppl 5(Pt 1):299-305.

Abstract

The objective of this study was to determine the prevalence of left ventricular (LV) dysfunction in patients with advanced interstitial lung disease (ILD) and the relationship between LV function and factors limiting physical activity. In 2005-2006, 40 patients with end stage ILD were admitted with qualifications for lung transplantation (LT). From this group, 18 patients (7 women, 11 men) were referred for LT (active list), 22 patients (8 women, 14 men), who did not meet the ATS/ERS criteria for LT were excluded from this procedure (waiting list). All patients had echocardiography, spirometry, 6-min walking test (6MW), and gas exchange measurements. The following main echocariographic data that describe the LV function and morphology were taken into account: LVs, LVd, LVPWd, LVPWs, Ao, LA, ESV, EDV, and EF. We noted significant differences in LVPWd (P=0.01), ESV (P=0.01), and EDV (P=0.02), which presented lower values in patients on the active list compared with those on the waiting list. A positive correlation was found between 6MW and LVs (r=0.41), LA (r=0.45), ESV (r=0.62), and EDV (r=0.68). Correlations between spirometric, gas exchange, and left ventricle echocardiographic data were also observed. We conclude that patients on active list for lung transplantation present a decrease in the diameter and volume of the left ventricle. The latter change may influence the functional ability of interstitial lung disease patients.

摘要

本研究的目的是确定晚期间质性肺疾病(ILD)患者左心室(LV)功能障碍的患病率,以及左心室功能与限制体力活动因素之间的关系。2005年至2006年,40例终末期ILD患者因符合肺移植(LT)条件入院。在该组患者中,18例患者(7名女性,11名男性)被列入LT名单(活跃名单),22例患者(8名女性,14名男性)因不符合美国胸科学会/欧洲呼吸学会的LT标准而被排除在该程序之外(等待名单)。所有患者均接受了超声心动图、肺活量测定、6分钟步行试验(6MW)和气体交换测量。记录了以下描述左心室功能和形态的主要超声心动图数据:左心室收缩末期内径(LVs)、左心室舒张末期内径(LVd)、左心室后壁舒张末期厚度(LVPWd)、左心室后壁收缩期厚度(LVPWs)、主动脉内径(Ao)、左心房内径(LA)、收缩末期容积(ESV)、舒张末期容积(EDV)和射血分数(EF)。我们注意到左心室后壁舒张末期厚度(P = 0.01)、收缩末期容积(P = 0.01)和舒张末期容积(P = 0.02)存在显著差异,活跃名单上的患者与等待名单上的患者相比,这些值较低。6分钟步行试验距离与左心室收缩末期内径(r = 0.41)�左心房内径(r = 0.45)、收缩末期容积(r = 0.62)和舒张末期容积(r = 0.68)之间存在正相关。还观察到肺活量测定、气体交换和左心室超声心动图数据之间的相关性。我们得出结论,列入肺移植活跃名单的患者左心室直径和容积减小。后一种变化可能会影响间质性肺疾病患者的功能能力。

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