JAHA:肺动脉压和左心室每搏量联合评估预测肺栓塞患者不良事件

2021-09-06 MedSci原创 MedSci原创

这项研究首次证明了早期肺动脉收缩压/左心室每搏输出量在预测急性肺栓塞患者不良临床事件中的效用。肺动脉收缩压/左心室每搏输出量可能是高危肺栓塞心室不同步的替代指标,应进行预后评估。

某些超声心动图参数可作为血流动力学受损的肺栓塞患者不良事件的早期预测指标。


 
近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员对2014年至2020年期间由肺栓塞反应小组(PERT)评估的急性肺栓塞患者进行了观察性分析。

研究人员使用右心室比率比较了包括肺栓塞严重程度指数和CarlBova评分在内的临床预测算法的性能,以及比较通过将肺动脉收缩压除以左心室每搏输出量计算的左心室血流动力学指标。研究人员通过单变量和多变量分析评估了院内死亡率、心脏骤停和需要先进治疗的主要结局。

在符合纳入标准的343名患者中,215名患者具有完整的数据。肺动脉收缩压/左心室每搏输出量是主要结局明确的预测指标(比值比[OR]为2.31;P=0.005),其性能与肺栓塞严重程度指数(OR为1.43;P=0.06)或Bova分数(OR为1.28;P=0.01)一样或更好。
 
由此可见,这项研究首次证明了早期肺动脉收缩压/左心室每搏输出量在预测急性肺栓塞患者不良临床事件中的效用。肺动脉收缩压/左心室每搏输出量可能是高危肺栓塞心室不同步的替代指标,应进行预后评估。

原始出处:

Hayaan Kamran.et al.Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism.JAHA.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.019849

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    2021-09-08 zhaohui6731
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    2021-09-07 ms1000002136354097

    学习了

    0

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    2021-09-06 罗正琪

    很好的

    0

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通过超声心动图、计算机断层扫描或BNP/NT-proBNP和肌钙蛋白水平升高评估的RVD与低风险急性PE患者的短期死亡相关。

J Thromb Haemost:癌症患者尸检时肺栓塞情况

在癌症患者尸检时,PE的比例是相当大的。虽然研究人群不能代表总体癌症人群,但这表明PE是癌症患者重要的并发症。

Chest:心率可能是肺栓塞患者预后因素

肺栓塞患者入院心率与30天全因死亡率和肺栓塞相关死亡率呈正相关。

Eur Radiol: 双能CTA灌注缺损表现是否可提示肺栓塞患者预后不良?

双能CTA (DECTA)可以根据物质能量吸收的特征提示物质的组成,并已被用于检测PE。DECTA可以在不增加辐射剂量的情况下同时评估肺血管和实质内碘的分布。

JAMA Cardiol:4级肺栓塞临床概率评分(4PEPS)在减少肺栓塞过度影像学检查方面的应用

在减少影像学检查方面,4PEPS策略比之前提出的所有策略表现更好。