Urabe Chikara, Takaya Yoichi, Nakayama Rie, Nakamura Kazufumi, Ito Hiroshi
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Int Heart J. 2023 Mar 31;64(2):230-236. doi: 10.1536/ihj.22-574. Epub 2023 Mar 15.
Pulmonary hypertension (PH) often causes right-sided heart failure (HF), inducing organ damage. Shear wave elastography (SWE) is a novel ultrasound technique for characterizing tissue. Some studies have reported that shear wave dispersion slope (SWDS) enables the assessment of early hepatic damage in HF. This study aimed to evaluate the prognostic impact of SWDS in patients with PH.This single-center cohort study enrolled 36 patients with PH who underwent SWE at Okayama University Hospital between March 2018 and April 2021. Patients were divided into 2 groups on the basis of the median value of SWDS: low SWDS group (SWDS < 12.4 m/second/kHz, n = 18) and high SWDS group (SWDS ≥ 12.4 m/second/kHz, n = 18). The primary endpoint was the complex of all-cause death or hospitalization for HF. During the follow-up of 391 ± 288 days, all-cause death or hospitalization for HF occurred in 8 patients. One patient died in the low SWDS group. Three patients died and 4 patients were hospitalized for HF in the high group. Kaplan-Meier analysis revealed that the event-free survival rate was significantly worse in the high SWDS group than in the low SWDS group (log-rank, P = 0.01). In univariate Cox proportional hazards analysis, high SWDS was associated with the events (hazard ratio 10.8; 95% confidence interval 1.89-202, P = 0.005).An elevated SWDS was associated with a high rate of events in patients with PH. SWDS has the potential to predict adverse outcomes in patients with PH.
肺动脉高压(PH)常导致右心衰竭(HF),进而引起器官损害。剪切波弹性成像(SWE)是一种用于表征组织的新型超声技术。一些研究报告称,剪切波离散斜率(SWDS)能够评估HF患者的早期肝损害。本研究旨在评估SWDS对PH患者预后的影响。
这项单中心队列研究纳入了36例PH患者,这些患者于2018年3月至2021年4月在冈山大学医院接受了SWE检查。根据SWDS的中位数将患者分为两组:低SWDS组(SWDS < 12.4米/秒/千赫兹,n = 18)和高SWDS组(SWDS≥12.4米/秒/千赫兹,n = 18)。主要终点是全因死亡或HF住院的复合终点。在391±288天的随访期间,8例患者发生了全因死亡或HF住院。低SWDS组有1例患者死亡。高SWDS组有3例患者死亡,4例患者因HF住院。Kaplan-Meier分析显示,高SWDS组的无事件生存率明显低于低SWDS组(对数秩检验,P = 0.01)。在单变量Cox比例风险分析中,高SWDS与事件相关(风险比10.8;95%置信区间1.89 - 202,P = 0.005)。
SWDS升高与PH患者的高事件发生率相关。SWDS有可能预测PH患者的不良结局。