Cardiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Cardiology Department, Ankara Education and Research Hospital, Ankara, Turkey.
Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):56S-62S. doi: 10.1177/1076029618785771. Epub 2018 Jul 11.
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.
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。