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CHA2DS2-VASc 评分与急性肺血栓栓塞症患者右心功能障碍的关系。

Relationship Between CHA2DS2-VASc Score and Right Ventricular Dysfunction in Patients With Acute Pulmonary Thromboembolism.

机构信息

Cardiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Cardiology Department, Ankara Education and Research Hospital, Ankara, Turkey.

出版信息

Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):56S-62S. doi: 10.1177/1076029618785771. Epub 2018 Jul 11.

Abstract

In this study, the association between the right ventricular dysfunction (RVD) and CHA2DS2-VASc (C: congestive heart failure or left ventricular systolic dysfunction, H: hypertension, A: age of ≥ 75 years, D: diabetes mellitus, S: previous stroke, V: vascular disease, A: age between 65 and 74 years, Sc: female gender) scores was investigated in patients with acute pulmonary thromboembolism (PTE). The patients have been assigned to 3 subgroups as massive, submassive, and nonmassive PTE. The CHA2DS2-VASc scores were calculated for all of the patients, and the scores have been classified into 3 groups as the scores between 0 and 1, the scores of 2, and the scores of 3 and over. The independent predictors of the RVD were investigated by the univariate and multivariate regression analyses. The independent predictors of the RVD were determined to be the CHA2DS2-VASc scores ( = .034), the systolic pulmonary artery pressure ( < .001), the presence of acute deep vein thrombosis ( = .007), high simplified Pulmonary Embolism Severity Index ( < .001), D-dimer ( < .006), and the mean platelet volume ( < .001). The CHA2DS2-VASc scores predicted the RVD with 70% sensitivity and 50% specificity as determined by the receiver operating characteristic analysis. The CHA2DS2-VASc score is an independent predictor of the RVD in patients with acute PTE.

摘要

在这项研究中,研究了急性肺血栓栓塞症(PTE)患者右心功能障碍(RVD)与 CHA2DS2-VASc(C:充血性心力衰竭或左心室收缩功能障碍,H:高血压,A:年龄≥75 岁,D:糖尿病,S:既往卒中,V:血管疾病,A:年龄 65-74 岁,Sc:女性)评分之间的关系。将患者分为大块、次大块和非大块 PTE 三组。计算了所有患者的 CHA2DS2-VASc 评分,并将评分分为 0-1 分、2 分和 3 分以上三组。通过单变量和多变量回归分析研究 RVD 的独立预测因子。多变量回归分析确定 CHA2DS2-VASc 评分(=0.034)、收缩性肺动脉压(<0.001)、急性深静脉血栓形成(=0.007)、简化的肺栓塞严重指数较高(<0.001)、D-二聚体(<0.006)和平均血小板体积(<0.001)是 RVD 的独立预测因子。通过受试者工作特征分析,CHA2DS2-VASc 评分预测 RVD 的敏感性为 70%,特异性为 50%。CHA2DS2-VASc 评分是急性 PTE 患者 RVD 的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce9e/6714857/6d3284414052/10.1177_1076029618785771-fig1.jpg

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