Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Cardiology, Nagoya University Hospital, Nagoya, Japan.
Can J Physiol Pharmacol. 2020 Sep;98(9):653-658. doi: 10.1139/cjpp-2019-0640. Epub 2020 Sep 13.
The 2015 European Society of Cardiology/European Respiratory Society guidelines for the diagnosis and treatment of pulmonary hypertension include a multidimensional risk assessment for patients with pulmonary arterial hypertension (PAH). However, prognostic validations of this risk assessment are limited, especially outside Europe. Here, we validated the risk assessment strategy in PAH patients in our institution in Japan. Eighty consecutive PAH patients who underwent right heart catheterization between November 2006 and December 2018 were analyzed. Patients were classified as low, intermediate, or high risk by using a simplified version of the risk assessment that included seven variables: World Health Organization functional class, 6-min walking distance, peak oxygen consumption, brain natriuretic peptide, right atrial pressure, mixed venous oxygen saturation, and cardiac index. The high-risk group showed significantly higher mortality than the low- or intermediate-risk group at baseline ( < 0.001 for both comparisons), and the mortalities in the intermediate- and low-risk groups were both low ( = 0.989). At follow-up, patients who improved to or maintained a low-risk status showed better survival than those who did not ( = 0.041). Our data suggest that this risk assessment can predict higher mortality risk and long-term survival in PAH patients in Japan.
2015 年欧洲心脏病学会/欧洲呼吸学会肺动脉高压诊断和治疗指南包括对肺动脉高压（PAH）患者进行多维风险评估。然而，这种风险评估的预后验证有限，尤其是在欧洲以外地区。在这里，我们验证了日本机构中 PAH 患者的风险评估策略。分析了 2006 年 11 月至 2018 年 12 月期间接受右心导管检查的 80 例连续 PAH 患者。使用简化的风险评估版本，包括七个变量（世界卫生组织功能分类、6 分钟步行距离、峰值氧耗量、脑钠肽、右心房压、混合静脉血氧饱和度和心指数）将患者分为低危、中危或高危。高危组在基线时的死亡率明显高于低危或中危组（两者比较均 < 0.001），中危组和低危组的死亡率均较低（=0.989）。随访时，风险状况改善或维持为低危的患者的生存率优于未改善的患者（=0.041）。我们的数据表明，这种风险评估可以预测日本 PAH 患者的更高死亡率风险和长期生存率。
