超声心动图与右心导管检查在识别肺动脉高压作为肝移植障碍方面的相关性。
The correlation in echocardiogram to right heart catheterization in identifying pulmonary hypertension as a barrier to liver transplantation.
机构信息
University of Alabama Birmingham Hospital, Department of Internal Medicine, Birmingham, AL, USA.
University of Alabama Birmingham Hospital, Department of Internal Medicine, Birmingham, AL, USA.
出版信息
Am J Med Sci. 2023 Jun;365(6):496-501. doi: 10.1016/j.amjms.2023.03.012. Epub 2023 Mar 16.
BACKGROUND
Pulmonary hypertension (PH) and portopulmonary hypertension (POPH) can be limitations towards listing for liver transplantation (LT). Our study evaluates the correlation of right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure (mPAP) on transthoracic echocardiogram (TTE) compared to mPAP on right heart catheterization (RHC).
METHODS
We performed a retrospective review of 723 patients who underwent LT evaluation at our institution between 2012 and 2020. Our cohort consisted of patients with RVSP and mPAP measured on TTE. A Wald t-test and area under the curve analysis were used for statistical analyses.
RESULTS
Patients with higher mPAP values on TTE (N=33) did not correlate with mPAP ≥ 35 mmHg on RHC, while patients with higher RVSP values (N=147) on TTE were associated with mPAP ≥ 35 mmHg on RHC. The cutoff value of RVSP ≥ 48 mmHg on TTE was associated with mPAP ≥ 35 mmHg on RHC.
CONCLUSIONS
Our data suggest that RVSP compared to mPAP on TTE is a better indicator for mPAP ≥ 35 mmHg on RHC. RVSP can be used as a marker on echocardiography for identifying patients with a higher likelihood of PH being a barrier to LT listing.
背景
肺动脉高压（PH）和门肺高压（POPH）可能是肝移植（LT）适应证的限制因素。我们的研究评估了经胸超声心动图（TTE）测量的右心室收缩压（RVSP）和肺动脉平均压（mPAP）与右心导管检查（RHC）测量的 mPAP 之间的相关性。
方法
我们对 2012 年至 2020 年在我们机构接受 LT 评估的 723 名患者进行了回顾性分析。我们的队列包括在 TTE 上测量 RVSP 和 mPAP 的患者。采用 Wald t 检验和曲线下面积分析进行统计学分析。
结果
TTE 上 mPAP 值较高的患者（N=33）与 RHC 上 mPAP≥35mmHg 不相关，而 TTE 上 RVSP 值较高的患者（N=147）与 RHC 上 mPAP≥35mmHg 相关。TTE 上 RVSP≥48mmHg 的临界值与 RHC 上 mPAP≥35mmHg 相关。
结论
我们的数据表明，与 TTE 上的 mPAP 相比，RVSP 是 RHC 上 mPAP≥35mmHg 的更好指标。RVSP 可作为超声心动图上的标志物，用于识别 PH 较高的患者，这些患者可能是 LT 适应证的障碍。
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