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艾森曼格综合征患者肺功能受损与心力衰竭之间的相关性及差异分析

Insights to correlations and discrepancies between impaired lung function and heart failure in Eisenmenger patients.

作者信息

Gumbiene Lina, Kapleriene Lina, Jancauskaite Dovile, Laukyte-Sleniene Monika, Jureviciene Elena, Rudiene Virginija, Paleviciute Egle, Mataciunas Mindaugas, Sileikiene Virginija

机构信息

Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Pulm Circ. 2020 Feb 28;10(1):1350650120909729. doi: 10.1177/2045894019899239. eCollection 2020 Jan-Mar.

Abstract

Impaired lung function and spirometric signs of airway obstruction without common risk factors for chronic obstructive pulmonary disease could be found in patients with Eisenmenger syndrome. This study aimed to analyse the association between lung function parameters and disease severity (including heart failure markers, associated congenital heart defect) as well as the possible reasons for airflow obstruction in Eisenmenger syndrome. The data of 25 patients with Eisenmenger syndrome were retrospectively evaluated. The patients were divided into groups according to airflow obstruction and a type of congenital heart defect. Airflow obstruction was found in nearly third (32%) of our cases and was associated with older age and worse survival. No relation was found between airway obstruction, B-type natriuretic peptide level, complexity of congenital heart defect and bronchial compression. Most of the patients (88%) had gas diffusion abnormalities. A weak negative correlation was noticed between gas diffusion (diffusing capacity of the lung for carbon monoxide) and B-type natriuretic peptide level (r = -0.437, p = 0.033). Increased residual volume was associated with higher mortality (p = 0.047 and p = 0.021, respectively). A link between B-type natriuretic peptide and lung diffusion, but not airway obstruction, was found. Further research and larger multicentre studies are needed to evaluate the importance of pulmonary function parameters and mechanisms of airflow obstruction in Eisenmenger syndrome.

摘要

艾森曼格综合征患者可能存在肺功能受损及气道阻塞的肺量计体征,而无慢性阻塞性肺疾病的常见风险因素。本研究旨在分析肺功能参数与疾病严重程度(包括心力衰竭标志物、相关先天性心脏缺陷)之间的关联,以及艾森曼格综合征气流阻塞的可能原因。对25例艾森曼格综合征患者的数据进行回顾性评估。根据气流阻塞情况和先天性心脏缺陷类型将患者分组。在近三分之一(32%)的病例中发现气流阻塞,且其与年龄较大和生存率较差相关。未发现气道阻塞、B型利钠肽水平、先天性心脏缺陷复杂性与支气管受压之间存在关联。大多数患者(88%)存在气体扩散异常。气体扩散(肺一氧化碳弥散量)与B型利钠肽水平之间存在弱负相关(r = -0.437,p = 0.033)。残气量增加与较高死亡率相关(分别为p = 0.047和p = 0.021)。发现B型利钠肽与肺扩散之间存在关联,但与气道阻塞无关。需要进一步研究和更大规模的多中心研究来评估肺功能参数的重要性及艾森曼格综合征气流阻塞的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edc0/7052468/e32438d1299e/10.1177_2045894019899239-fig1.jpg

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