Ojima Satoko, Kubozono Takuro, Saihara Keishi, Miyauchi Takahiro, Kawasoe Shin, Kubota Kayoko, Shigemizu Sanae, Ohtsubo Hideo, Miyata Masaaki, Ohishi Mitsuru
Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima Japan.
Center for Rheumatic Diseases, Japanese Red Cross Kagoshima Hospital Kagoshima Japan.
Circ Rep. 2019 Nov 9;1(12):610-616. doi: 10.1253/circrep.CR-19-0087.
Pulmonary hypertension (PH) is an important cause of morbidity in patients with connective tissue disease (CTD), and an early stage of PH could present as exercise-induced PH (EIPH). This study investigated the significant clinical indexes of EIPH in patients with CTD. We enrolled 63 patients with CTD who did not have PH at rest. All patients underwent the 6-min walk test (6MWT), and systolic pulmonary artery pressure (SPAP) was evaluated on echocardiography before and after 6MWT. EIPH was defined as SPAP ≥40 mmHg after 6 WMT. Thirty-five patients had EIPH. On univariate logistic analysis, SPAP at rest, log brain natriuretic peptide (BNP), vital capacity (VC), and forced expiratory volume in 1 s (FEV1.0) were significantly correlated with EIPH. On multiple logistic analysis, SPAP at rest and VC were independent predictors of EIPH, whereas FEV1.0 and log BNP were not significantly associated with EIPH. The area under the receiver operating characteristics curve between EIPH and BNP, SPAP at rest, VC or FEV1.0 was 0.67, 0.76, 0.74, and 0.75, respectively. SPAP at rest and respiratory function, especially VC, could be independent predictors of EIPH in patients with CTD.
肺动脉高压（PH）是结缔组织病（CTD）患者发病的重要原因，PH的早期阶段可能表现为运动性肺动脉高压（EIPH）。本研究调查了CTD患者EIPH的重要临床指标。我们纳入了63例静息时无PH的CTD患者。所有患者均进行了6分钟步行试验（6MWT），并在6MWT前后通过超声心动图评估收缩期肺动脉压（SPAP）。EIPH定义为6MWT后SPAP≥40 mmHg。35例患者有EIPH。单因素逻辑分析显示，静息时的SPAP、脑钠肽（BNP）对数、肺活量（VC）和第1秒用力呼气量（FEV1.0）与EIPH显著相关。多因素逻辑分析显示，静息时的SPAP和VC是EIPH的独立预测因素，而FEV1.0和BNP对数与EIPH无显著相关性。EIPH与BNP、静息时的SPAP、VC或FEV1.0之间的受试者工作特征曲线下面积分别为0.67、0.76、0.74和0.75。静息时的SPAP和呼吸功能，尤其是VC，可能是CTD患者EIPH的独立预测因素。
