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通过肺脉搏传播时间评估人类免疫缺陷病毒感染患者的肺动脉血流动力学和血管变化

Assessment of Pulmonary Arterial Hemodynamic and Vascular Changes by Pulmonary Pulse Transit Time in Patients with Human Immunodeficiency Virus Infection.

作者信息

Erdol Mehmet Akif, Acar Burak, Ertem Ahmet Goktug, Karanfil Mustafa, Yayla Çağrı, Demırtas Koray, Aladağ Pelin, Sönmezer Meliha Çağla, Kiliç Esra Kaya, Hatipoğlu Çiğdem Ataman, Erdinc Fatma Sebnem, Tulek Necla, Akcay Adnan Burak

机构信息

Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.

Department of Cardiology, Kocaeli University, Kocaeli, Turkey.

出版信息

J Cardiovasc Echogr. 2021 Jan-Mar;31(1):6-10. doi: 10.4103/jcecho.jcecho_103_20. Epub 2021 May 21.

Abstract

INTRODUCTION

Pulmonary arterial hypertension and human immunodeficiency virus (HIV) infection is a well-known association. Pulmonary pulse transit time (pPTT) is a recent echocardiographic marker that might be used for evaluation of pulmonary arterial stiffness (PAS) in patients with HIV infection. We aimed to investigate whether pPTT elevated in patients with HIV infection compared to healthy controls and its association with echocardiographic indices of right ventricular functions.

MATERIALS AND METHODS

Fifty HIV (+) patients from infectious disease outpatient clinics and fifty age- and sex-matched HIV (-) healthy volunteers were enrolled in this study. pPTT was measured from pulmonary vein flow velocity as the time interval between the R-wave in the electrocardiography and corresponding peak late systolic was then calculated as the mean from two separate pw-Doppler measurements.

RESULTS

pPTT, tricuspid annular peak systolic excursion (TAPSE) and right ventricle fractional area change (FAC) were significantly lower in patients with HIV than control patients (177.1 ± 34.9 vs. 215.7 ± 35.7 msn, < 0.001; 2.33 ± 0.28 vs. 2.19 ± 0.22, = 0.039; 45 [4.25] vs. 41.1 [4.0], = 0.032, respectively). pPTT was positively correlated with FAC, TAPSE and cluster of differentiation 4 count ( = 0.210; = 0.036, r = 0.256; = 0.041, r = 0.304; = 0.044, respectively).

CONCLUSION

Our study showed that pPTT, TAPSE, and right ventricle FAC levels were lower in patients with HIV infection. pPTT is an important predictor in patients with HIV expected to develop pulmonary vascular pathology.

摘要

引言

肺动脉高压与人类免疫缺陷病毒(HIV)感染之间的关联已为人熟知。肺脉搏传播时间(pPTT)是一种最新的超声心动图标志物,可用于评估HIV感染患者的肺动脉僵硬度(PAS)。我们旨在研究与健康对照相比,HIV感染患者的pPTT是否升高,以及它与右心室功能超声心动图指标之间的关联。

材料与方法

本研究纳入了50名来自传染病门诊的HIV(+)患者以及50名年龄和性别匹配的HIV(-)健康志愿者。通过肺静脉血流速度测量pPTT,即心电图中R波与相应的晚期收缩期峰值之间的时间间隔,然后通过两次独立的pw-多普勒测量计算平均值。

结果

HIV患者的pPTT、三尖瓣环收缩期峰值位移(TAPSE)和右心室面积变化分数(FAC)显著低于对照组患者(分别为177.1±34.9 vs. 215.7±35.7 ms,P<0.001;2.33±0.28 vs. 2.19±0.22,P = 0.039;45 [4.25] vs. 41.1 [4.0],P = 0.032)。pPTT与FAC、TAPSE和分化簇4计数呈正相关(分别为r = 0.210,P = 0.036;r = 0.256,P = 0.041;r = 0.304,P = 0.044)。

结论

我们的研究表明,HIV感染患者的pPTT、TAPSE和右心室FAC水平较低。pPTT是预期会发生肺血管病变的HIV患者的重要预测指标。

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