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REVEAL注册研究:肺动脉高压患者右心导管检查与超声心动图的相关性

REVEAL Registry: correlation of right heart catheterization and echocardiography in patients with pulmonary arterial hypertension.

作者信息

Farber Harrison W, Foreman Aimee J, Miller Dave P, McGoon Michael D

机构信息

Boston University School of Medicine, 715 Albany Street, Boston, MA 02118, USA.

出版信息

Congest Heart Fail. 2011 Mar-Apr;17(2):56-64. doi: 10.1111/j.1751-7133.2010.00202.x. Epub 2011 Jan 27.

Abstract

Cardiopulmonary hemodynamics are estimated by Doppler echocardiogram (ECHO) and measured by right heart catheterization (RHC) in patients with pulmonary arterial hypertension (PAH). Whether there is a correlation between these measurements is controversial. The authors investigated ECHO and RHC in patients enrolled in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL), a multicenter, observational, US-based study designed to provide current information about patients with PAH. Patients with PAH who had an ECHO and RHC within 12 months of each other were included. Correlation between subsequent ECHO and RHC was also investigated. Of 2967 patients, 2838 were 18 years and older at enrollment and 1883 had an RHC within 12 months of an ECHO. Correlations between ECHO-estimated and RHC-measured pulmonary artery systolic pressures (PASPs) and mean right atrial pressures did not change based on temporal proximity of the two baseline studies, whether they occurred on the same day or were separated by up to 12 months. In contrast, there was little correlation of serial measurements between ECHO and RHC. Although there is good correlation in PASP between ECHO and RHC at baseline, repeat ECHO measurements alone are not sufficient to monitor change in PASP or progression of PAH.

摘要

在肺动脉高压(PAH)患者中,通过多普勒超声心动图(ECHO)评估心肺血流动力学,并通过右心导管插入术(RHC)进行测量。这些测量之间是否存在相关性存在争议。作者在参与评估早期和长期PAH疾病管理注册研究(REVEAL)的患者中研究了ECHO和RHC,这是一项多中心、观察性、基于美国的研究,旨在提供有关PAH患者的当前信息。纳入了在彼此12个月内进行过ECHO和RHC检查的PAH患者。还研究了后续ECHO和RHC之间的相关性。在2967例患者中,2838例在入组时年龄为18岁及以上,1883例在ECHO检查后12个月内进行了RHC检查。ECHO估计的和RHC测量的肺动脉收缩压(PASPs)以及平均右心房压力之间的相关性,不会因两项基线研究的时间接近程度而改变,无论它们是在同一天进行还是相隔长达12个月。相比之下,ECHO和RHC的系列测量之间几乎没有相关性。尽管在基线时ECHO和RHC的PASP之间存在良好的相关性,但仅重复进行ECHO测量不足以监测PASP的变化或PAH的进展。

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