Wu Chun-Hsin, Lin Chun-Yu, Hsu Chih-Hsin, Lin Sheng-Hsiang, Weng Chia-Tse
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Division of Rheumatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Healthcare (Basel). 2021 May 20;9(5):615. doi: 10.3390/healthcare9050615.
: Pulmonary arterial hypertension (PAH) is a life-threatening disease with different etiologies and outcomes. We aimed to explore differences in clinical features and outcomes of idiopathic PAH (iPAH) and connective tissue disease-related PAH (CTD-PAH) in Taiwanese patients and determine risk factors for mortality. : We retrospectively reviewed the medical records of patients with right-sided heart catheterization-diagnosed PAH between January 2005 and December 2015. The iPAH ( = 31) and CTD-PAH ( = 14) patients were enrolled and followed until December 31, 2019. Between-group comparisons were conducted. Potential predictors of the mortality of PAH were determined using the Cox proportional hazard regression model. : CTD-PAH patients had higher levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower predicted diffusing capacity of carbon monoxide (DLCO) than iPAH patients. The mortality rates were similar between CTD-PAH and iPAH (21.4% vs. 22.6%, = 0.99). A mean pulmonary arterial pressure (mPAP) > 46 mmHg was a predictor of PAH-induced mortality (adjusted hazard ratio 21.8, 95% confidence interval 2.32-204.8). : A higher mPAP level, but not underlying CTDs, imposed a significantly increased risk of mortality to patients with PAH.
肺动脉高压(PAH)是一种病因和预后各异的危及生命的疾病。我们旨在探讨台湾患者特发性PAH(iPAH)和结缔组织病相关PAH(CTD-PAH)的临床特征和预后差异,并确定死亡的危险因素。我们回顾性分析了2005年1月至2015年12月期间经右心导管检查诊断为PAH的患者的病历。纳入iPAH(n = 31)和CTD-PAH(n = 14)患者并随访至2019年12月31日。进行组间比较。使用Cox比例风险回归模型确定PAH死亡的潜在预测因素。CTD-PAH患者的N末端脑钠肽前体(NT-proBNP)水平高于iPAH患者,而一氧化碳预测弥散量(DLCO)低于iPAH患者。CTD-PAH和iPAH的死亡率相似(21.4%对22.6%,P = 0.99)。平均肺动脉压(mPAP)> 46 mmHg是PAH所致死亡的预测因素(调整后风险比21.8,95%置信区间2.32 - 204.8)。较高的mPAP水平而非潜在的CTD会使PAH患者的死亡风险显著增加。