Baltazares-Lipp Mario E, Aguilera-Velasco Alberto, Aquino-Gálvez Arnoldo, Velázquez-Cruz Rafael, Hernández-Zenteno Rafael J, Alvarado-Vásquez Noé, Camarena Angel, Sierra-Vargas M Patricia, Chávez-Pacheco Juan L, Ruiz Víctor, Salinas-Lara Citlaltepetl, Tena-Suck Martha L, Romero Yair, Torres-Espíndola Luz M, Castillejos-López Manuel
Department of Hemodynamics and Echocardiography, National Institute of Respiratory Diseases Ismael Cosio Villegas, Mexico City 14080, Mexico.
Epidemiology and Statistics Department, National Institute of Respiratory Diseases Ismael Cosio Villegas, Mexico City 14080, Mexico.
Diagnostics (Basel). 2021 Jul 20;11(7):1297. doi: 10.3390/diagnostics11071297.
Pulmonary hypertension is a rare condition that impairs patients' quality of life and life expectancy. The development of noninvasive instruments may help elucidate the prognosis of this cardiorespiratory disease. We aimed to evaluate the utility of routinely performed noninvasive test results as prognostic markers in patients with pulmonary hypertension. We enrolled 198 patients with mean pulmonary artery pressure >25 mmHg measured at cardiac catheterisation or echocardiographic pulmonary artery systolic pressure > 40 mmHg and tricuspid regurgitation Vmax >2.9 m/s, and clinical information regarding management and follow-up studies from the date of diagnosis. Multivariate analysis revealed that female sex [HR: 0.21, (95% CI: 0.07-0.64); = 0.006], the presence of collagenopathies [HR: 8.63, (95% CI: 2.38-31.32); = 0.001], an increased red blood cell distribution width [HR: 1.25, (95% CI: 1.04-1.49); = 0.017] and an increased electrocardiographic P axis (P°)/T axis (T°) ratio [HR: 0.93, (95% CI: 0.88-0.98); = 0.009] were severity-associated factors, while older age [HR: 1.57, (95% CI: 1.04-1.28); = 0.006], an increased QRS axis (QRS°)/T° ratio [HR: 1.21, (95% CI: 1.09-1.34); < 0.001], forced expiratory volume in 1 s [HR: 0.94, (95% CI: 0.91-0.98); = 0.01] and haematocrit [HR: 0.93, (95% CI: 0.87-0.99); = 0.04] were mortality-associated factors. Our results support the importance of red blood cell distribution width, electrocardiographic ratios and collagenopathies for assessing pulmonary hypertension prognosis.
肺动脉高压是一种罕见疾病，会损害患者的生活质量和预期寿命。无创仪器的发展可能有助于阐明这种心肺疾病的预后。我们旨在评估常规进行的无创检查结果作为肺动脉高压患者预后标志物的效用。我们纳入了198例患者，这些患者在心脏导管检查时测得平均肺动脉压>25 mmHg，或超声心动图测得肺动脉收缩压>40 mmHg且三尖瓣反流Vmax>2.9 m/s，并收集了自诊断之日起有关治疗和随访研究的临床信息。多变量分析显示，女性[风险比（HR）：0.21，（95%置信区间：0.07 - 0.64）；P = 0.006]、存在结缔组织病[HR：8.63，（95%置信区间：2.38 - 31.32）；P = 0.001]、红细胞分布宽度增加[HR：1.25，（95%置信区间：1.04 - 1.49）；P = 0.017]以及心电图P轴（P°）/T轴（T°）比值增加[HR：0.93（95%置信区间：0.88 - 0.98）；P = 0.009]是与病情严重程度相关的因素，而年龄较大[HR：1.57，（95%置信区间：1.04 - 1.28）；P = 0.006]、QRS轴（QRS°）/T°比值增加[HR：1.21，（95%置信区间：1.09 - 1.34）；P < 0.001]、第1秒用力呼气量[HR：0.94，（95%置信区间：0.91 - 0.98）；P = 0.01]和血细胞比容[HR：0.93，（95%置信区间：0.87 - 0.99）；P = 0.04]是与死亡率相关的因素。我们的结果支持红细胞分布宽度、心电图比值和结缔组织病对于评估肺动脉高压预后的重要性。
