Enea Iolanda, Ghio Stefano, Bongarzoni Amedeo, Casazza Franco, D'Armini Andrea Maria, Favretto Giuseppe, Roncon Loris, Rubboli Andrea, Serafini Oscar, Zonzin Pietro, D'Agostino Carlo
Dipartimento d'Emergenza, AORN 5. Anna e San Sebastiano, Caserta.
G Ital Cardiol (Rome). 2010 May;11(5):402-7.
Pulmonary hypertension is characterized by an increase in pulmonary vascular resistance and premature death. Echocardiography is useful in the screening of patients with suspected pulmonary hypertension by estimation of the systolic regurgitant tricuspid flow velocity according to the simplified Bernoulli equation. On this basis, the survey INCIPIT was created aiming at evaluating the frequency of suspected pulmonary hypertension among Italian patients.
From November 10 to 29, 2008, echo laboratories were invited to report on a special electronic file the number of echocardiographic examinations performed and the number of those showing a peak tricuspid regurgitant flow velocity > or = 3 m/s.
123 echo labs participated in the study. 21 483 echocardiograms were evaluated from 110 centers (58, 17 and 35 in North, Center and South Italy, respectively); 1410 (6.6%) exams showed a systolic regurgitant flow velocity > or = 3 m/s (median value 3.3 and interquartile range 0.46). Patients were predominantly female (female to male ratio 734/676), with a mean age of 71.8 +/- 11.8 years, median body mass index of 25.7 kg/m2 (interquartile range 5.5). Overall, 21.4% patients had no symptoms, 48.7% had dyspnea, 11.2% had asthenia, 3.9% had chest pain, and 7.4% had dyspnea and asthenia. Among the 1410 patients with a tricuspid regurgitant flow velocity > or = 3 m/s, 52.62% had left heart disease, 7.52% lung disease, 1.35% chronic thromboembolic pulmonary hypertension, 0.92% collagen disease, 0.43% congenital heart disease, 0.14% liver disease, 0.07% HIV, 26.45% more than one disease, and 10.5% presented suspected pulmonary hypertension of unknown cause.
In the Italian echo labs, the occurrence of suspected pulmonary hypertension is not uncommon. Cardiologists should be encouraged to refer patients with suspected pulmonary hypertension of unknown origin to specialized centers in order to define the cause of pulmonary hypertension and to institute the appropriate therapy.
肺动脉高压的特征是肺血管阻力增加和过早死亡。超声心动图可通过根据简化伯努利方程估算三尖瓣反流收缩期流速，有助于筛查疑似肺动脉高压患者。在此基础上，开展了INCIPIT调查，旨在评估意大利患者中疑似肺动脉高压的发生率。
2008年11月10日至29日，邀请超声心动图实验室在一个特殊电子文件中报告所进行的超声心动图检查数量以及三尖瓣反流峰值流速≥3m/s的检查数量。
123个超声心动图实验室参与了该研究。对来自110个中心（意大利北部、中部和南部分别为58个、17个和35个）的21483份超声心动图进行了评估；1410份（6.6%）检查显示收缩期反流流速≥3m/s（中位数为3.3，四分位间距为0.46）。患者以女性为主（女性与男性比例为734/676），平均年龄为71.8±11.8岁，体重指数中位数为25.7kg/m²（四分位间距为5.5）。总体而言，21.4%的患者无症状，48.7%有呼吸困难，11.2%有乏力，3.9%有胸痛，7.4%有呼吸困难和乏力。在1410例三尖瓣反流流速≥3m/s的患者中，52.62%有左心疾病，7.52%有肺部疾病，1.35%有慢性血栓栓塞性肺动脉高压，0.92%有胶原病，0.43%有先天性心脏病，0.14%有肝脏疾病，0.07%有HIV感染，26.45%有不止一种疾病，10.5%表现为病因不明的疑似肺动脉高压。
在意大利的超声心动图实验室中，疑似肺动脉高压的情况并不少见。应鼓励心脏病专家将病因不明的疑似肺动脉高压患者转诊至专科中心，以明确肺动脉高压的病因并进行适当治疗。
