Pulmonary Divison, Heart Institute, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
PLoS One. 2021 Mar 17;16(3):e0248214. doi: 10.1371/journal.pone.0248214. eCollection 2021.
The characterization of pulmonary arterial hypertension (PAH) relies mainly on right heart catheterization (RHC). Electrical impedance tomography (EIT) provides a non-invasive estimation of lung perfusion that could complement the hemodynamic information from RHC. To assess the association between impedance variation of lung perfusion (ΔZQ) and hemodynamic profile, severity, and prognosis, suspected of PAH or worsening PAH patients were submitted simultaneously to RHC and EIT. Measurements of ΔZQ were obtained. Based on the results of the RHC, 35 patients composed the PAH group, and eight patients, the normopressoric (NP) group. PAH patients showed a significantly reduced ΔZQ compared to the NP group. There was a significant correlation between ΔZQ and hemodynamic parameters, particularly with stroke volume (SV) (r = 0.76; P < 0.001). At 60 months, 15 patients died (43%) and 1 received lung transplantation; at baseline they had worse hemodynamics, and reduced ΔZQ when compared to survivors. Patients with low ΔZQ (≤154.6%.Kg) presented significantly worse survival (P = 0.033). ΔZQ is associated with hemodynamic status of PAH patients, with disease severity and survival, demonstrating EIT as a promising tool for monitoring patients with pulmonary vascular disease.
肺高血压（PAH）的特征主要依赖于右心导管检查（RHC）。电阻抗断层成像（EIT）提供了一种非侵入性的肺灌注估计方法，可以补充 RHC 的血流动力学信息。为了评估肺灌注阻抗变化（ΔZQ）与血流动力学特征、严重程度和预后之间的相关性，疑似 PAH 或病情恶化的 PAH 患者同时接受 RHC 和 EIT 检查。测量了 ΔZQ。根据 RHC 的结果，35 名患者组成 PAH 组，8 名患者组成正常血压（NP）组。PAH 患者的 ΔZQ 明显低于 NP 组。ΔZQ 与血流动力学参数之间存在显著相关性，特别是与每搏量（SV）（r = 0.76；P < 0.001）。在 60 个月时，15 名患者死亡（43%），1 名患者接受了肺移植；在基线时，与幸存者相比，他们的血流动力学更差，ΔZQ 更低。ΔZQ 较低（≤154.6%.Kg）的患者生存率明显更差（P = 0.033）。ΔZQ 与 PAH 患者的血流动力学状态、疾病严重程度和生存率相关，表明 EIT 是监测肺血管疾病患者的一种很有前途的工具。
