Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary emb...Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.展开更多
目的探讨B型尿钠肽(BNP)对鉴别呼吸困难病因方面的临床价值。方法将180例急性呼吸困难患者分为心源性呼吸困难组(119例)和肺源性呼吸困难组(61例)。分别比较心源性和肺源性呼吸困难组不同亚组之间BNP水平、左室射血分数(LVEF)、左室舒...目的探讨B型尿钠肽(BNP)对鉴别呼吸困难病因方面的临床价值。方法将180例急性呼吸困难患者分为心源性呼吸困难组(119例)和肺源性呼吸困难组(61例)。分别比较心源性和肺源性呼吸困难组不同亚组之间BNP水平、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)水平,计算BNP诊断心源性呼吸困难的受试者工作特征(ROC)曲线下面积及最佳界值。结果心源性呼吸困难组BNP水平(ng/mL)较肺源性组明显升高(655～1250 vs 75.6～141.8,P<0.001);BNP鉴别诊断的最佳界值为100 pg/mL,准确率80%。结论急性呼吸困难患者BNP的测定有助于心源性和肺源性病因的判定;且可评估心源性呼吸困难患者的危重程度;BNP是独立评估LVEF、LVEDD异常的指标。展开更多
BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and le...BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.展开更多
文摘Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.
基金National Natural Science Foundation of China (81673955)Provincial Key Research and Development Project of Hunan (2022SK2012)Hunan University of Chinese Medicine Graduate Innovation Project (2022CX133)。
文摘目的探讨B型尿钠肽(BNP)对鉴别呼吸困难病因方面的临床价值。方法将180例急性呼吸困难患者分为心源性呼吸困难组(119例)和肺源性呼吸困难组(61例)。分别比较心源性和肺源性呼吸困难组不同亚组之间BNP水平、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)水平,计算BNP诊断心源性呼吸困难的受试者工作特征(ROC)曲线下面积及最佳界值。结果心源性呼吸困难组BNP水平(ng/mL)较肺源性组明显升高(655～1250 vs 75.6～141.8,P<0.001);BNP鉴别诊断的最佳界值为100 pg/mL,准确率80%。结论急性呼吸困难患者BNP的测定有助于心源性和肺源性病因的判定;且可评估心源性呼吸困难患者的危重程度;BNP是独立评估LVEF、LVEDD异常的指标。
文摘BACKGROUND Coronary heart disease(CHD)causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life.AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODS A total of 106 patients with CHD(study group)and 106 healthy individuals(control group)in our hospital from March 2019 to September 2020 were selected for this study.All subjects were examined by ultrasound,and the mitral orifice’s early-to-late diastolic blood flow velocity ratio(E/A),left ventricular end-diastolic volume(LVDd),and left atrial diameter(LAD)were measured.Values were compared between the study group and healthy group,and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed.In addition,the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTS E/A(1.46±0.34)of the study group was smaller than that of the control group(1.88±0.44),while LVDd(58.24±5.05 mm)and LAD(43.31±4.38 mm)were larger(48.15±3.93 and 34.94±2.81,respectively;P<0.05).E/A for patients with grade III disease(1.41±0.43)was smaller and their LVDd(60.04±4.21 mm)and LA(44.16±2.79 mm)were larger than those in patients with grade II disease(1.71±0.48,52.18±3.67 mm,and 39.68±2.37,respectively;P<0.05).Patients with grade IV disease had smaller E/A(1.08±0.39)and larger LVDd(66.81±5.39 mm)and LAD(48.81±3.95 mm)than patients with grade II and III disease(P<0.05).In patients with moderate disease,E/A(1.44±0.41)was smaller and LVDd(59.95±4.14 mm)and LAD(45.15±2.97 mm)were larger than in patients with mild disease(1.69±0.50,51.97±3.88 and 38.81±2.56 mm,respectively;P<0.05).In patients with severe disease,E/A(1.13±0.36)was smaller and LVDd(67.70±6.11 mm)and LAD(49.09±4.05 mm)were larger than in patients with moderate disease(P<0.05).E/A was negatively correlated with cardiac function classi-fication and disease severity,while LVDd and LAD were positively correlated with cardiac function classification and disease severity(P<0.05).E/A(1.83±0.51)for patients with good prognosis was higher than that for those with poor prognosis(1.39±0.32),while LVDd(49.60±4.39 mm)and LAD(36.13±3.05 mm)were lower(P<0.05).CONCLUSION The ultrasonic parameters of patients with CHD are abnormal,and differ significantly in patients with different cardiac function grades,lesion degree,and prognosis.
