Prognostic significance of pericardial effusion in systemic sclerosis-associated pulmonary hypertension: analysis from the PHAROS Registry.
Prognostic significance of pericardial effusion in systemic sclerosis-associated pulmonary hypertension: analysis from the PHAROS Registry.
复制标题
心包积液在系统性硬化症相关肺动脉高压中的预后意义：来自 PHAROS 注册的分析。
DOI：
10.1093/rheumatology/kead368
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
PHAROSInvestigators
中科院分区：
文献类型：
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作者：
Luo,Yiming;Gordon,JessicaK;Xu,Jiehui;Kolstad,KathleenD;Chung,Lorinda;Steen,VirginiaD;Bernstein,ElanaJ;PHAROSInvestigators
目的肺动脉高压（PH）是SSc患者的主要死亡原因。本研究的目的是确定心包积液的预后意义与SSc-PH.MethodsPulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma（PHAROS）患者是一个前瞻性的多中心注册登记，招募新诊断的SSc-PH患者从2005年至2016年。分析了心包积液状态对预后的影响，包括曾经或从未发生心包积液的患者，以及持续性或间歇性心包积液的患者。Kaplan-Meier生存分析，对数秩检验，多变量考克斯比例风险回归进行了performed.ResultsOf 335例SSc-PH诊断右心导管和文件的心包积液的存在或不存在的超声心动图，166（50%）曾经有心包积液。曾经有心包积液不能预测生存率（对数秩检验P = 0.49）。在245名至少进行了两次超声心动图检查的SSc-PH患者中，44%的患者在平均4.3年的随访中心包积液状态发生了变化。持续性心包积液是生存率的独立预测因子[校正风险比（aHR）=2.34，95%CI 1.20，4.64，P = 0.002]，而间歇性心包积液不是生存率的预测因子（aHR = 0.89，95%CI 0.52，1.56，P = 0.68）。结论持续性心包积液，但从未有心包积液或间歇性心包积液，与较差的生存率独立相关。从连续超声心动图中获得的信息可能有助于临床医生更好地预测SSc-PH患者的生存率。
ObjectivesPulmonary hypertension (PH) is a leading cause of death in patients with SSc. The purpose of this study was to determine the prognostic significance of pericardial effusion in patients with SSc-PH.MethodsPulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) is a prospective multicentre registry which enrolled patients with newly diagnosed SSc-PH from 2005 to 2016. The prognostic impact of pericardial effusion status, including those who ever or never had pericardial effusion, and those who had persistent or intermittent pericardial effusion, was analysed. Kaplan–Meier survival analyses, log-rank test, and multivariable Cox proportional hazards regression were performed.ResultsOf the 335 patients with SSc-PH diagnosed by right heart catheterization and documentation of pericardial effusion presence or absence on echocardiogram, 166 (50%) ever had pericardial effusion. Ever having pericardial effusion was not predictive of survival (log-rank testP= 0.49). Of the 245 SSc-PH patients who had at least two echocardiograms, 44% had a change in pericardial effusion status over an average of 4.3 years of follow up. Having a persistent pericardial effusion was an independent predictor of survival [adjusted hazard ratio (aHR)=2.34, 95% CI 1.20, 4.64,P= 0.002], while intermittent pericardial effusion was not a predictor of survival (aHR = 0.89, 95% CI 0.52, 1.56,P= 0.68), in a multivariable-adjusted analysis.ConclusionPersistent pericardial effusion, but not ever having had pericardial effusion or intermittent pericardial effusion, was independently associated with poorer survival. Incorporating information from serial echocardiograms may help clinicians better prognosticate survival in their SSc-PH patients.