毛细血管前性肺动脉高压的静脉超声检查及右心导管检查
Venous excess ultrasound and right heart catheterization in pre-capillary pulmonary hypertension.
作者信息
Alday-Ramírez Sergio M, Gómez-Rodríguez César A, Damas-de-Los-Santos Félix, Zebadúa-Torres Rodrigo, Leal-Villarreal Mario A J, Zayas Nayeli, Jasso-Molina Juan C, Hernández-Oropeza José Luis, Soliman-Aboumarie Hatem, Argaiz Eduardo R
机构信息
Department of Echocardiography, Instituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Belisario Domínguez Sección XVI, Tlalpan, 14030, Mexico City, México.
Department of Interventional Cardiology, Instituto Nacional de Cardiología 'Ignacio Chávez', Belisario Domínguez Sección XVI, Juan Badiano 1Tlalpan, 14030, Mexico City, México.
出版信息
J Ultrasound. 2025 Jul 2. doi: 10.1007/s40477-025-01050-7.
AIMS
Venous congestion is an important determinant of organ dysfunction in patients with pulmonary hypertension. Currently, there are no optimal methods for non-invasive assessment of venous congestion. We aimed to evaluate the accuracy of the recently described venous excess ultrasound grading system (VExUS) to determine the presence of venous congestion in patients with precapillary pulmonary hypertension compared to right heart catheterization.
METHODS
We included patients with precapillary pulmonary hypertension undergoing right heart catheterization. VExUS was performed by trained cardiologists simultaneous with catheterization. Correlation and simple logistic regression between invasive hemodynamic measurement and VExUS was performed.
RESULTS
Forty-nine patients with precapillary pulmonary hypertension were included. A significant correlation between VExUS and right atrial pressure (RAP) was found (R = 0.70, p < 0.001). VExUS was an excellent predictor of RAP > 10 mmHg (AUC 0.93, p < 0.001).
CONCLUSION
Our study provides evidence that VExUS score is a reliable, non-invasive method for assessing right atrial pressure in patients with pre-capillary PH.
目的
静脉淤血是肺动脉高压患者器官功能障碍的重要决定因素。目前，尚无用于无创评估静脉淤血的最佳方法。我们旨在评估最近描述的静脉过多超声分级系统（VExUS）与右心导管检查相比，在确定毛细血管前性肺动脉高压患者静脉淤血存在方面的准确性。
方法
我们纳入了接受右心导管检查的毛细血管前性肺动脉高压患者。由训练有素的心脏病专家在导管检查的同时进行VExUS检查。对有创血流动力学测量与VExUS之间进行相关性和简单逻辑回归分析。
结果
纳入了49例毛细血管前性肺动脉高压患者。发现VExUS与右心房压力（RAP）之间存在显著相关性（R = 0.70，p <0.001）。VExUS是RAP> 10 mmHg的优秀预测指标（AUC 0.93，p <0.001）。
结论
我们的研究提供了证据，表明VExUS评分是评估毛细血管前性肺动脉高压患者右心房压力的可靠无创方法。
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