无创血流动力学监测对早期HFpEF患者肺血流动力学指标及心室功能的评估价值

Application value of noninvasive hemodynamic monitoring in evaluating pulmonary hemodynamic index and ventricular function of HFpEF patients in early stage

目的:探讨无创血流动力学监测在评估早期左室射血分数保留型心力衰竭(Heart failure with preserved ejection fraction,HFpEF)患者肺血流动力学指标及心室功能中的应用价值。方法:选取2018年1月至2019年8月来我院心内科就诊的99例患者为研究对象,按左室舒张功能分为HFpEF组(n=45)和无心衰症状的左室舒张功能障碍(Left ventricular diastolic dysfunction,LVDD)组(n=44)。所有患者均采用免疫放射分析法测定血浆脑利钠肽(Brain natriuretic peptide,BNP)水平,并采用心脏超声组织多普勒检测和无创血流动力学监测肺血流动力学,比较两组患者相关指标之间的差异。结果:HFpEF组血浆BNP水平明显高于LVDD组(P<0.05),左室射血分数(Left ventricular ejection fraction,LVEF)明显低于LVDD组(P<0.05),而左房内径(Left atrial diameter,LAD)、左室舒张末内径(Left ventricular end-diastolic diameter,LVEDd)、左室短轴缩短率(Fractional shortening,FS)组间比较差异无统计学意义(P>0.05);心室射血前期指数(Ventricular ejection farction,Q-BI)、心室射血期指数(Ventricular ejection duration index,B-YI)、心肌紧张指数(Myocardial tension index,Q-B/B-Y)、肺平均动脉压(Mean pulmonary arterial pressure,PAP)明显高于LVDD组(P<0.05)。结论:无创血流动力学监测应用于早期HFpEF患者,能准确评估疾病发展过程中肺血流动力学指标变化情况。

Objective:To investigate the value of noninvasive hemodynamic monitoring in evaluating lung hemodynamic indexes and ventricular function in patients with early left ventricular ejection fraction(HFpEF).Methods:A total of 99 patients admitted to the department of Cardiology in our hospital from January 2018 to August 2019 were selected as study subjects.According to Left ventricular diastolic function,they were divided into Left ventricular ejection fraction reserved heart failure(HFpEF)group(n=45)and Left ventricular diastolic dysfunction(LVDD)group(n=44)with no symptoms of heart failure.Immunoradioassay was used to determine the level of Brain Natriuretic peptide(BNP)in all patients,and cardiac ultrasound tissue Doppler and noninvasive hemodynamic monitoring were used to compare the differences between the two groups.Results:The plasma level of BNP in the HFpEF group was significantly higher than that in the LVDD group(P<0.05),and the Left ventricular ejection fraction(LVEF)was significantly lower than that in the LVDD group(P<0.05),while the Left atrial diameter(LAD)and the Left ventricular end-diastolic diameter were obviously below the LVDD group(P<0.05).There was no statistically significant difference between the LVEDd group and the fractional shortening(FS)group(P>0.05).Ventricular ejection Farction(Q-BI),Ventricular ejection Duration index(B-YI),Myocardial tension index(Q-B/B-Y),and Mean pulmonary arterial pressure PAP was significantly higher than LVDD group(P<0.05).Conclusion:Non-invasive hemodynamic monitoring in patients with early HFpEF can accurately assess the changes of pulmonary hemodynamic indicators during disease development.