JAMA Cardiol:即使是无症状轻度肺动脉高压,死亡风险也明显增加

2019-09-26 朱柳媛 中国循环杂志

有些人在常规体检中做心脏超声检查时,会发现轻度肺动脉高压,但是没有明显的症状。   美国一项大规模队列研究提示,这些轻度肺动脉高压的患者会出现右心室功能障碍,死亡风险也明显增加,而且女士预后更差。   研究者指出,根据目前的威廉亚洲博彩公司 ,只有心脏超声检查时估计的右室收缩压超过40 mmHg时需要进一步评估。   该研究表明,心脏超声检查发现的轻度肺动脉高压(右室收

有些人在常规体检中做心脏超声检查时,会发现轻度肺动脉高压,但是没有明显的症状。
 
美国一项大规模队列研究提示,这些轻度肺动脉高压的患者会出现右心室功能障碍,死亡风险也明显增加,而且女士预后更差。
 
研究者指出,根据目前的威廉亚洲博彩公司 ,只有心脏超声检查时估计的右室收缩压超过40 mmHg时需要进一步评估。
 
该研究表明,心脏超声检查发现的轻度肺动脉高压(右室收缩压33~39 mmHg)的人群也有风险。
 
该研究显示,与右室收缩压正常(<33 mmHg)者相比,有轻度肺动脉高压的人右室功能较差,具体表现为三尖瓣环收缩期位移(TAPSE)较小(2.0 cm vs 2.2 cm),而且右室功能不全的比例几乎增倍(32.6% vs 16.7%)。
 
此外,有轻度肺动脉高压的人右心室-肺动脉耦合(TAPSE与右室收缩压的平均比值)明显降低(0.55 mm/mmHg vs 0.93mm/mmHg)。
 
研究者还发现,右室收缩压从27 mmHg起,患者校正后的死亡风险就开始增加(HR=1.32,95% CI:1.02-1.70)。
 
另外,在任何右室收缩压水平,女士的死亡风险均较高。
 
该研究共纳入47 784例患者,其中56%为女士,平均年龄59岁。

原始出处:
Jessica H. Huston, et al. Association of Mild Echocardiographic Pulmonary Hypertension With Mortality and Right Ventricular Function. JAMA Cardiol. Published online September 18, 2019.
 

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1925299, encodeId=baf3192529925, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33354, encryptionId=26d633354c9, topicName=动脉高压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Fri Apr 24 03:13:00 CST 2020, time=2020-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782065, encodeId=d61c1e82065c7, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Sat Oct 12 17:13:00 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373362, encodeId=b6563e336206, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Mon Sep 30 01:06:16 CST 2019, time=2019-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255903, encodeId=915e12559038a, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Sep 28 14:13:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485044, encodeId=25541485044f7, content=<a href='/topic/show?id=4bbe5902ed2' target=_blank style='color:#2F92EE;'>#无症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Sat Sep 28 14:13:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373287, encodeId=80b23e328786, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Sat Sep 28 06:30:22 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050860, encodeId=f99e1050860b6, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri Sep 27 02:13:00 CST 2019, time=2019-09-27, status=1, ipAttribution=)]
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    2019-09-28 txqjm

    谢谢了,学习

    0

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    2019-09-27 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

    0

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Circulation:功能性三尖瓣反流提示射血分数降低的心衰患者预后不良

功能性三尖瓣反流(FTR)在心力衰竭中常见,其射血分数降低,主要继发于肺动脉高压。但FTR的内在临床意义尚不完全明确。本研究对Mayo诊所2003年-2011年确诊的射血分数<50%的B-C期心衰患者进行研究,采用超声对FTR分级、评估收缩期肺动脉压。排除有起搏器/除颤器、器质性瓣膜病或既往做过瓣膜手术的患者。主要评估指标是总体死亡率。共纳入13026位患者,11507位(88%)患者检查出