Zhang Yu, Zhang Yongxiang, Liao Chang, Wang Xiaoxu
Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.
Exp Ther Med. 2023 Nov 17;27(1):18. doi: 10.3892/etm.2023.12306. eCollection 2024 Jan.
Chronic thromboembolic pulmonary hypertension (CTEPH) plays a key role in the deterioration of lung hemodynamics and contributes to secondary dysfunction of the right heart, which is consistently accompanied by systemic malperfusion and a reduced glomerular filtration rate (GFR). The prognosis of CTEPH is markedly influenced by renal function. The aim of the present study was to evaluate the prognostic value of GFR in patients with CTEPH who have undergone balloon pulmonary angioplasty (BPA). From December 2012 to September 2020, a total of 47 patients diagnosed with CTEPH who received BPA were retrospectively studied. Patients were categorized according to their renal function on admission into two groups: GFR >53 and ≤53. Biological, clinical and demographic data of the patients were collected. Data for the two groups in hospital and during follow-up were systematically analyzed and compared. All-cause mortality, death from right heart failure (RHF) and rehospitalization associated with RHF were considered major adverse events (MAEs). The results revealed that the 6-min walk distance, N-terminal pro-B type natriuretic peptide (NT-proBNP), Troponin I and right ventricle diameter were significantly lower, and tricuspid annular plane systolic excursion was significantly higher in the GFR >53 group compared with the GFR ≤53 group at final follow-up. In addition, GFR levels were significantly correlated with NT-proBNP at baseline and final follow-up. Furthermore, based on a multivariate analysis, it was determined that the decreased GFR was an independent predictor of MAEs during follow-up. Therefore, it may be concluded that in addition to being associated with right ventricular function, decreased GFR is also a prognostic marker in CTEPH treated with BPA.
慢性血栓栓塞性肺动脉高压（CTEPH）在肺血流动力学恶化中起关键作用，并导致右心继发性功能障碍，同时常伴有全身灌注不良和肾小球滤过率（GFR）降低。CTEPH的预后受肾功能的显著影响。本研究的目的是评估GFR对接受球囊肺动脉血管成形术（BPA）的CTEPH患者的预后价值。回顾性研究了2012年12月至2020年9月期间共47例诊断为CTEPH并接受BPA的患者。根据入院时的肾功能将患者分为两组：GFR>53和≤53。收集患者的生物学、临床和人口统计学数据。系统分析并比较两组患者住院期间和随访期间的数据。全因死亡率、右心衰竭（RHF）死亡和与RHF相关的再次住院被视为主要不良事件（MAE）。结果显示，在最后随访时，GFR>53组的6分钟步行距离、N末端B型利钠肽原（NT-proBNP）、肌钙蛋白I和右心室直径显著低于GFR≤53组，而三尖瓣环平面收缩期位移显著高于GFR≤53组。此外，在基线和最后随访时，GFR水平与NT-proBNP显著相关。此外，基于多变量分析，确定GFR降低是随访期间MAE的独立预测因素。因此，可以得出结论，除了与右心室功能相关外，GFR降低也是接受BPA治疗的CTEPH的预后标志物。
