目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm ...目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm Hg)、重度组30例(≥70 mm Hg),比较各组下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差、肺动脉平均压(mPAP)、肺毛细血管阻力(PVR)、肺毛细血管楔压(PCWP)的差异;分析下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差与肺动脉收缩压、mPAP、PVR、PCWP的相关性。结果观察组下腔静脉塌陷指数、右室长轴应变、PCWP均低于对照组,mPAP、PVR、三尖瓣反流压差均高于对照组,差异均有统计学意义(均P<0.05)。重度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻、中度组,mPAP、PVR、三尖瓣反流压差均高于轻、中度组,中度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻度组,mPAP、PVR、三尖瓣反流压差均高于轻度组,差异均有统计学意义(均P<0.05)。相关性分析显示,下腔静脉塌陷指数、右室长轴应变与肺动脉收缩压均呈负相关(r=-0.796、-0.895,均P<0.05);三尖瓣反流压差与肺动脉收缩压呈正相关(r=0.541,P<0.05);下腔静脉塌陷指数、右室长轴应变与PVR均呈负相关(r=-0.410、-0.454,均P<0.05),与PCWP均呈正相关(r=0.262、0.288,均P<0.05);三尖瓣反流压差与mPAP、PVR、PCWP均呈正相关(r=0.589、0.657、0.653,均P<0.05)。结论PAH患者下腔静脉塌陷指数和右室长轴应变均明显降低,两者均与肺动脉收缩压呈负相关。展开更多
Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary ar...Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery(PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures. Some devices, such as the CardioM EMS and thoracic impedance monitors present as part of implantable cardiac defibrillators, are supported by a body of evidence which show the potential to reduce HF related morbidity and have received regulatory approval, whereas other devices have failed to show benefit and, in some cases, harm. Clearly these devices can convey a considerable amount of information and clinicians should start to familiarize themselves with their use and expect further development and refinement in the future.展开更多
文摘目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm Hg)、重度组30例(≥70 mm Hg),比较各组下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差、肺动脉平均压(mPAP)、肺毛细血管阻力(PVR)、肺毛细血管楔压(PCWP)的差异;分析下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差与肺动脉收缩压、mPAP、PVR、PCWP的相关性。结果观察组下腔静脉塌陷指数、右室长轴应变、PCWP均低于对照组,mPAP、PVR、三尖瓣反流压差均高于对照组,差异均有统计学意义(均P<0.05)。重度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻、中度组,mPAP、PVR、三尖瓣反流压差均高于轻、中度组,中度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻度组,mPAP、PVR、三尖瓣反流压差均高于轻度组,差异均有统计学意义(均P<0.05)。相关性分析显示,下腔静脉塌陷指数、右室长轴应变与肺动脉收缩压均呈负相关(r=-0.796、-0.895,均P<0.05);三尖瓣反流压差与肺动脉收缩压呈正相关(r=0.541,P<0.05);下腔静脉塌陷指数、右室长轴应变与PVR均呈负相关(r=-0.410、-0.454,均P<0.05),与PCWP均呈正相关(r=0.262、0.288,均P<0.05);三尖瓣反流压差与mPAP、PVR、PCWP均呈正相关(r=0.589、0.657、0.653,均P<0.05)。结论PAH患者下腔静脉塌陷指数和右室长轴应变均明显降低,两者均与肺动脉收缩压呈负相关。
文摘Hemodynamic monitoring has long formed the cornerstone of heart failure(HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery(PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures. Some devices, such as the CardioM EMS and thoracic impedance monitors present as part of implantable cardiac defibrillators, are supported by a body of evidence which show the potential to reduce HF related morbidity and have received regulatory approval, whereas other devices have failed to show benefit and, in some cases, harm. Clearly these devices can convey a considerable amount of information and clinicians should start to familiarize themselves with their use and expect further development and refinement in the future.