Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension: Detection by cardiac magnetic resonance
Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension: Detection by cardiac magnetic resonance
复制标题
系统性硬化症相关肺动脉高压患者的双心室相互作用：心脏磁共振检测
DOI：
10.1080/14397595.2016.1218597
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发表时间：
2016
期刊：
影响因子：
2.2
通讯作者：
T.
中科院分区：
文献类型：
--
作者：
Noguchi;A. Kato;M. Kono;M. Ohmura;K. Ohira;H. Tsujino;I. Oyama-Manabe;N. Oku;K. Bohgaki;T. Horita;T. Yasuda;S. Nishimura;M. Atsumi;T.
目的：与其他结缔组织疾病（CTD）相关的肺动脉高压（PAH）相比，系统性硬化症（SSc）相关的PAH预后较差。本研究的目的是通过进行心脏磁共振（CMR）成像来检查SSc-PAH与其他CTD-PAH之间血流动力学状态的差异。方法：对2010年1月至2015年10月同期接受右心导管插入术和CMR的40例连续CTD患者进行了单中心回顾性分析。结果：32例患者有毛细血管前肺动脉高压。其中，15例患有SSc，17例患有其他CTD。CMR测量值，特别是右与左舒张末期容积的比值（RVEDV/LVEDV），与平均肺动脉压（mPAP）相关性良好。相反，RVEDV/LVEDV和mPAP在SSc和非SSc患者中的相关性不同。在SSc患者中，RVEDV/LVEDV与mPAP的比值显著高于非SSc患者。在随访研究中，2例SSc患者在治疗后尽管mPAP降低，但仍表现出RVEDV/LVEDV增加。Kaplan-Meier分析显示，RVEDV/LVEDV增加后treatment.Conclusions患者预后不良：我们的数据表明，改变双心室的相互作用检测CMR可能代表SSC相关的心脏受累，并反映预后不良的SSc-PAH。
Objectives: Pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) has a poor prognosis compared to PAH associated with other connective tissue diseases (CTD). The objective of this study was to examine the difference in hemodynamic state between SSc-PAH and other CTD-PAH by performing cardiac magnetic resonance (CMR) imaging.Methods: A single center retrospective analysis was conducted comprising 40 consecutive CTD patients who underwent right heart catheterization and CMR at the same period from January 2010 to October 2015.Results: Thirty-two patients had pre-capillary pulmonary hypertension. Of these, 15 had SSc and 17 had other CTD. CMR measurements, particularly the ratio of right to left end-diastolic volume (RVEDV/LVEDV), correlated well with mean pulmonary arterial pressure (mPAP). Conversely, RVEDV/LVEDV and mPAP correlated differently in SSc and non-SSc patients. In SSc patients, the ratio of RVEDV/LVEDV to mPAP was significantly higher compared to non-SSc patients. In the follow-up study, 2 SSc patients exhibited increased RVEDV/LVEDV in spite of decreased mPAP following treatment. Kaplan–Meier analysis revealed poor prognosis of patients with increased RVEDV/LVEDV following treatment.Conclusions: Our data indicated that altered bi-ventricular interplay detected at CMR may represent SSc-related cardiac involvement and reflect poor prognosis of SSc-PAH.