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右心室功能正常的原发性肺动脉高压会导致下肢静脉功能不全。

Primary pulmonary arterial hypertension with preserved right ventricular function leads to lower extremity venous insufficiency.

作者信息

Aldemir Mustafa, Emren Sadık Volkan, Balçık Çınar, Onrat Ersel, Gürsoy Merve

机构信息

1 Department of Cardiovascular Surgery, Afyon Kocatepe University, Afyonkarahisar, Turkey.

2 Department of Cardiology, Izmir Katip Celebi University, Izmir, Turkey.

出版信息

Vascular. 2018 Apr;26(2):183-188. doi: 10.1177/1708538117723201. Epub 2017 Aug 23.

Abstract

Objectives Pulmonary hypertension with heart failure is related to venous insufficiency. However, there is no clear data whether pulmonary arterial hypertension with preserved right ventricular function cause venous insufficiency. In this study, we aim to investigate the relation between pulmonary arterial pressure with venous insufficiency in pulmonary arterial hypertension patients with preserved right ventricular function. Methods Between January 2012 and October 2014, 38 patients with a diagnosis of pulmonary arterial hypertension and 47 control group patients were included. Venous disability score and venous segmental disease score of both groups were calculated in order to measure venous insufficiency. The relationship between venous disability score and venous segmental disease scores and mean pulmonary arterial pressure and World Heart Organization functional capacity was examined. Results Total venous segmental disease score (5 ± 3.9 vs. 2 ± 1.8 p < 0.001), right venous segmental disease score (2.6 ± 2.2 vs. 1 ± 0.9 p < 0.001), left venous segmental disease score (2.4 ± 2.2 vs. 1 ± 0.9 p < 0.001), and venous disability scores (2.2 ±1 vs. 1.6 ± 0.7 p < 0.001) of patients with pulmonary arterial hypertension were higher than the control group. While the total venous segmental disease score was highly related to mean pulmonary arterial pressure (r = 0.829, p < 0.001), the venous disability score was only weakly related (r = 0.343, p = 0.037). Total venous segmental disease score (r = 0.606, p < 0.001) and venous disability scores (r = 0.601, p < 0.001) were moderately related with World Health Organization functional capacity intensity. Conclusions The degree of venous insufficiency increase in accordance with the mean pulmonary arterial pressure even in patients with preserved right ventricular function.

摘要

目的 伴有心力衰竭的肺动脉高压与静脉功能不全有关。然而,尚无明确数据表明右心室功能保留的肺动脉高压是否会导致静脉功能不全。在本研究中,我们旨在探讨右心室功能保留的肺动脉高压患者的肺动脉压与静脉功能不全之间的关系。方法 纳入2012年1月至2014年10月期间诊断为肺动脉高压的38例患者和47例对照组患者。计算两组的静脉功能障碍评分和静脉节段性疾病评分以评估静脉功能不全。研究静脉功能障碍评分和静脉节段性疾病评分与平均肺动脉压及世界心脏组织心功能分级之间的关系。结果 肺动脉高压患者的总静脉节段性疾病评分(5±3.9 对比 2±1.8,p<0.001)、右侧静脉节段性疾病评分(2.6±2.2 对比 1±0.9,p<0.001)、左侧静脉节段性疾病评分(2.4±2.2 对比 1±0.9,p<0.001)和静脉功能障碍评分(2.2±1 对比 1.6±0.7,p<0.001)均高于对照组。虽然总静脉节段性疾病评分与平均肺动脉压高度相关(r=0.829,p<0.001),但静脉功能障碍评分仅呈弱相关(r=0.343,p=0.037)。总静脉节段性疾病评分(r=0.606,p<0.001)和静脉功能障碍评分(r=0.601,p<0.001)与世界卫生组织心功能分级强度呈中度相关。结论 即使在右心室功能保留的患者中,静脉功能不全的程度也随平均肺动脉压升高而增加。

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