Chest:BMI与肺动脉压有因果关系,但与肺血管重构的血流动力学参数无关

2020-07-24 MedSci原创 MedSci原创

BMI是PAH和PVH患者肺动脉高压严重程度的介导因素,但仅与PVH的发病机理有关。

肥胖与肺动脉高压(PAH)和肺静脉高压(PVH)的发病机理和严重程度之间的关系尚未明确。体重指数(BMI)是否与肺动脉压力(PAP)和/或肺血管重塑标志相关?

近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究人员从GWAS汇总数据中构建了两个BMI遗传风险评分,并将它们用于右心导管检查(RHC)或超声心动图检查的受试者的非重叠队列。研究人员采用具有最佳多态性的BMI风险评分(BMI_hpGRS)以评估肥胖与其他特征的共享遗传结构,并与RHC参数(包括肺血管重塑标记)相关联。孟德尔随机分析采用由高可信度遗传变异组成的BMI遗传风险评分(BMI_sGRS),以评估较高BMI是否引起较高的PAP。

在所有受试者中,直接测量的BMI和BMI_hpGRS均与肺动脉压呈正相关,但与肺血管重塑的标志无关。分类分析显示,BMI和BMI_hpGRS与PVH相关,但与PAH不相关。BMI_sGRS的孟德尔随机化分析支持较高的BMI是较高的收缩期肺动脉压(sPAP)的原因。敏感性分析表明,当排除PAH或PVH个体时,sPAP与BMI_sGRS之间的关系仍然存在。在超声心动图队列中,BMI和BMI_hpGRS与估计的PAP和左心重塑标志物呈正相关。

由此可见,BMI是PAH和PVH患者肺动脉高压严重程度的介导因素,但仅与PVH的发病机理有关。

原始出处:

Timothy E. Thayer.et al.BMI is causally associated with pulmonary artery pressure but not hemodynamic evidence of pulmonary vascular remodeling.chest.2020.https://journal.chestnet.org/article/S0012-3692(20)32057-2/fulltext

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    2021-02-27 Smile2680
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    2020-07-25 清卿

    肥胖患者易发生肺动脉高压?

    0

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