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建立甲状腺功能亢进症患者肺动脉高压的预测模型。

Establishment of a prediction model of pulmonary artery hypertension in patients with hyperthyroidism.

机构信息

Department of Ultrasound Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, China.

Department of Ultrasound Medicine, Fuyang City Women and Children Hospital, Fuyang City, Anhui Province, China.

出版信息

Ann Noninvasive Electrocardiol. 2024 Sep;29(5):e13133. doi: 10.1111/anec.13133.

Abstract

OBJECTIVE

This study aims to assess the tricuspid annular plane systolic excursion (TAPSE)/PASP ratio as a potential indicator for predicting the probability of developing pulmonary arterial hypertension (PAH) in hyperthyroidism patients. A nomogram model will be developed based on our findings, as well as the receiver operating characteristic (ROC) curve.

METHODS

The study involved 166 hyperthyroid patients treated at Yijishan Hospital, and the period covered August 2021 to August 2022. Patients were divided into two groups according to pulmonary artery systolic pressure ≥35 mmHg. Univariate and multivariate logistic analyses were performed on the two groups' demographic and laboratory data to identify potential diagnostic markers. These parameters were evaluated using ROC curves to determine their precision in forecasting PAH. The findings were validated by plotting a calibration curve based on a line chart model.

RESULTS

In the study, eventually, 80 patients were enrolled: 30 in the PAH group and 50 in the No PAH group. Multipleistic regression analysis predicted the occurrence risk of developing PAH. When paired with other conventional echocardiographic parameters (such as TAPSE, MPI, and SV) and serological markers (such as FT3 and FT4), the developed model demonstrated outstanding predictive performance with an area under the ROC curve of 0.985, a Youden index of 0.971, a sensitivity of 100%, and a specificity of 97.1%.

CONCLUSIONS

The nomogram model constructed by combining the TAPSE/PASP ratio with FT3 and FT4 serum markers, as well as conventional ultrasound parameters SV and MPI in hyperthyroidism patients, demonstrates robust discriminatory ability and consistency.

摘要

目的

本研究旨在评估三尖瓣环平面收缩期位移(TAPSE)/肺动脉收缩压(PASP)比值作为预测甲状腺功能亢进症患者发生肺动脉高压(PAH)概率的潜在指标。我们将根据研究结果建立列线图模型,并绘制受试者工作特征(ROC)曲线。

方法

该研究纳入了 2021 年 8 月至 2022 年 8 月在弋矶山医院治疗的 166 例甲状腺功能亢进症患者。根据肺动脉收缩压≥35mmHg 将患者分为两组。对两组的人口统计学和实验室数据进行单因素和多因素逻辑分析,以确定潜在的诊断标志物。使用 ROC 曲线评估这些参数,以确定其预测 PAH 的准确性。根据折线图模型绘制校准曲线对研究结果进行验证。

结果

最终纳入 80 例患者:PAH 组 30 例,无 PAH 组 50 例。多因素回归分析预测了发生 PAH 的风险。当与其他常规超声心动图参数(如 TAPSE、MPI 和 SV)和血清标志物(如 FT3 和 FT4)联合使用时,所建立的模型具有出色的预测性能,ROC 曲线下面积为 0.985,约登指数为 0.971,灵敏度为 100%,特异性为 97.1%。

结论

在甲状腺功能亢进症患者中,将 TAPSE/PASP 比值与 FT3、FT4 血清标志物以及 SV 和 MPI 等常规超声参数相结合构建的列线图模型具有较强的鉴别能力和一致性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b5/11391270/fd2dda2cebff/ANEC-29-e13133-g003.jpg

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