左心功能相关参数及左右心室内径比值与中重度肺动脉高压患者预后的关系

目的:探讨超声心动图无创测量左心功能相关参数及左右心室内径比值与中重度肺动脉高压患者预后的关系.方法:回顾性分析2019年1月至2020年11月我院心内科住院的中重度肺动脉高压患者90例,并依据随访中临床恶化[包括全因死亡、肺移植、因肺动脉高压恶化再住院、肺动脉高压治疗升级(增加口服靶向药物种类或增加剂量或增加皮下或静...

Relationship of Left Ventricular Functional Parameters and the Ratio of Left/Right Ventricular Diameters With the Prognosis of Patients With Moderate to Severe Pulmonary Hypertension

Objectives:To explore the relationship of left ventricular functional parameters and the ratio of left/right ventricular diameters with the prognosis of patients with moderate to severe pulmonary hypertension.Methods:This retrospective analysis included 90 patients with moderate to severe pulmonary hypertension who were hospitalized in the department of cardiology in our hospital from January 2019 to November 2020.According to the clinical worsening during follow-up,they were divided into clinical worsening group and non-clinical worsening group.Univariate and multivariate Cox proportional hazard regression models and Kaplan-Meier survival curves were used to analyze the relationship between echocardiography-derived variables and the prognosis of enrolled patients.Results:Eighty-six out of 90 enrolled patients with moderate to severe pulmonary hypertension completed the followup.During a median follow-up period of 12.1(9.1,14.3)months,clinical worsening event occurred in 34 cases.Compared with the non-clinical worsening group,patients in the clinical worsening group had lower left ventricular cardiac output(CO_Echo),left ventricular cardiac index(CI_Echo),left ventricular end diastolic diameter/proximal inner diameter of the right ventricular outflow tract(LVEDd/RVOT-prox),shorter the six-minute walking distance(6MWD)and higher end diastolic right ventricular/left ventricular basal segment transverse diameter ratio(RVTDd/LVTDd)(all P<0.05).Multivariate Cox regression analysis showed that CI_Echoand LVEDd/RVOT-prox were the independent risk factors for predicting the prognosis of patients with moderate to severe PH(P=0.027,P=0.021).Kaplan-Meier survival curve showed that the incidence of clinical worsening was significantly increased in patients with CI_Echo<2.710 L/(min·m²)(P=0.001)and LVEDd/RVOT-prox<1.064(P=0.001).Conclusions:Echocardiography derived ventricular functional and structural parameters CI_Echo and LVEDd/RVOT-prox can be used to predict the incidence of clinical worsening in patients with moderate to severe pulmonary hypertension.