Arthritis Rheumatol:系统性硬化症患者右心室输出储备减少,肺动脉压轻度升高

2019-01-08 xiangting MedSci原创

这项研究结果表明,mPAP轻度升高的SSc患者6MWD受损可能是由运动期间的PAC减少和RV输出储备减少引起的。

这项前瞻性研究目的是评估系统性硬化症(SSc)患者静息和运动期间的右心室功能和肺动脉顺应性(PAC=每搏输出量/脉压),这些SSc患者静息时的平均肺动脉压正常(mPAP)、或mPAP轻度升高(mPAP 21-24mmHg)或出现肺动脉高压(mPAP≥25mmHg)。

SSc患者(n=112)在静息和运动过程中接受临床评估和右心导管检查,并根据其静息mPAP值分为3组: mPAP正常(≤20mmHg)、mPAP轻度升高(21-24mmHg)和肺部高血压(PH,mPAP≥25mmHg)。通过ANOVA比较组间的结果,然后进行事后学生t检验。

与mPAP正常的患者相比,mPAP轻度升高的患者运动期间的6分钟步行距离较短(6MWD; p<0.008)、心脏指数较低(CI)(p=0.027)和PVR较高(p=0.0002)。静息时(p=0.016)和不同运动阶段(25瓦p=0.033,75瓦p=0.024)的PAC较低。

这项研究结果表明,mPAP轻度升高的SSc患者6MWD受损可能是由运动期间的PAC减少和RV输出储备减少引起的,推测是由于右心室与肺血管系统之间的耦合受损。这些发现进一步证明了mPAP轻度升高在SSc患者中的临床相关性。

原始出处:

Christian Nagel. Reduced right ventricular output reserve in patients with systemic sclerosis and mildly elevated pulmonary arterial pressures. Arthritis Rheumatol. 07 January 2019.

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    2019-01-10 zhaojie88
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