Ann Rheum Dis:系统性硬化症的血流动力学表型和生存率

2019-12-10 xiangting MedSci原创

这项研究的数据表明PVR阈值≥3WU太高,无法早期诊断PAH。PVR阈值≥2WU已与肺血管疾病相关,生存率大大降低,更适合轻度PAH的SSc患者。

这项研究探讨了第6届世界肺动脉高压大会提出的新肺动脉高压(PAH)血流动力学定义对系统性硬化症患者(SSc)表型和生存率的影响。

纳入在海德堡或苏黎世接受前瞻性和连续性包括右心导管检查在内PAH筛查SSc患者,根据新的PAH定义重新评估患者的血流动力学和临床指标。对患者进行3.7±3.7年(中位数3.4)的随访;进行Kaplan-Meier生存分析。比较分析排除了患有严重肺或左心疾病的患者。

最终数据集包括284SSc患者,146名患者(49.2%)平均肺动脉压(mPAP≤20mmHg19.3%的患者mPAP 21-24mmHg29.4%的患者mPAP≥25mmHg。在mPAP轻度升高组中,只有4名患者(占整个SSc队列的1.4%)的肺血管阻力(PVR)值≥3 Wood单位(WU),可以被重新分类为明显SSc-APAHmPAP 21–24mmHgPVR≥2 WU28名患者(9.8%)已出现早期肺血管疾病,6分钟步行距离(6MWD)缩短(p<0.001),TAPSEp=0.004)和肺动脉顺应性降低(p<0.001)。PVR≥2 WU与长期生存率降低相关(p=0.002)。在多因素分析中,PVR6MWD是独立的预后指标。

这项研究的数据表明PVR阈值≥3WU太高,无法早期诊断PAHPVR阈值≥2WU已与肺血管疾病相关,生存率大大降低,更适合轻度PAHSSc患者。

原始出处:

Panagiota Xanthouli. Haemodynamic phenotypes and survival in patients with systemic sclerosis: the impact of the new definition of pulmonary arterial hypertension. Ann Rheum Dis. 09 December 2019.

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    2019-12-12 tastas
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