Clinical and hemodynamic features of acute pulmonary embolism patients diagnosed in cold weather predicts adverse clinical outcome.
Clinical and hemodynamic features of acute pulmonary embolism patients diagnosed in cold weather predicts adverse clinical outcome.
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寒冷天气诊断的急性肺栓塞患者的临床和血流动力学特征预示着不良的临床结果
DOI：
10.3389/fcvm.2022.1055926
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
--
作者：
急性肺栓塞（APE）的发病率和死亡率在冬季最高。本研究旨在描述寒冷天气对APE患者的临床和血流动力学特征。所有入选的224例APE患者均接受临床和血流动力学评估，并收集基线参数。招募的患者按入院时的天气模式分为寒冷和温暖天气组。分析了寒冷天气与其他变量之间的相关性和预报价值。与温暖天气组相比，寒冷天气组患者的心功能更严重，WHO功能分级更差（P = 0.032），NT-proBNP浓度更高[1，853.0（398.0，5，237.0）pg/ml vs. 847.5（56.8，3，090.5）pg/ml，P = 0.001]。寒冷天气组血流动力学状态更危险，血栓负荷更重，mPAP更高（29.1 ± 11.2mmHg vs. 25.6 ± 14.2mmHg，P = 0.045），PVR较高[3.3（1.7，6.0）木材单位vs. 1.8（0.9，3.8）木单位，P < 0.001]，较高的米勒指数（21.4 ± 5.9 vs. 19.1 ± 8.0，P = 0.024）和较高的D-二聚体水平[2，172.0（854.5，3，072.5）mg/L vs. 1，094.5（210.5，2，914.5）mg/L，P = 0.008]。此外，寒冷的天气表现出良好的相关性与上述变量。生存分析显示，寒冷天气的APE患者的临床恶化事件发生率显著较高（P = 0.010），在多变量分析中，APE患者的临床恶化事件可能是不良临床结局的独立预测因素（HR 2.629; 95%CI 1.127，6.135; P = 0.025）。寒冷天气下APE患者血栓负荷过重、心功能不全、血流动力学衰竭和临床恶化事件发生率较高。寒冷的天气被证明是不良临床结果的独立预测因子。
Acute pulmonary embolism (APE) is associated with peak incidence and mortality rate in winter. The present study sought to characterize the clinical and hemodynamic features of cold weather on APE patients. All enrolled 224 APE patients underwent clinical and hemodynamic evaluation and baseline parameters were collected. Recruited patients were grouped by weather pattern on admission into cold and warm weather group. The correlation and prognostic values among cold weather and other variables were analyzed. Compared to warm weather group, patients in cold weather group present with more severe cardiac function, with adverse WHO-functional class (P = 0.032) and higher NT-proBNP concentration [1,853.0 (398.0, 5,237.0) pg/ml vs. 847.5 (56.8, 3,090.5) pg/ml, P = 0.001]. The cold weather group also displayed much critical hemodynamic status and heavier thrombosis load, with higher mPAP (29.1 ± 11.2mmHg vs. 25.6 ± 14.2mmHg, P = 0.045), higher PVR [3.3 (1.7, 6.0) wood units vs. 1.8 (0.9, 3.8) wood units, P < 0.001], higher Miller index (21.4 ± 5.9 vs. 19.1 ± 8.0, P = 0.024), and higher D-dimer levels [2,172.0 (854.5, 3,072.5) mg/L vs. 1,094.5 (210.5, 2,914.5) mg/L, P = 0.008]. Besides, cold weather showed well correlation with the above variables. Survival analysis showed APE patients in cold weather had significantly higher clinical worsening event rate (P = 0.010) and could be an independent predictor of adverse clinical outcome in the multivariate analysis (HR 2.629; 95% CI 1.127, 6.135; P = 0.025). APE patients in cold weather were associated with thrombus overload, cardiac dysfunction, hemodynamic collapse and higher clinical worsening event rate. Cold weather proves to be an independent predictor of adverse clinical outcome.
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影响因子：
6.7
作者：
Dentali, Francesco;Ageno, Walter;Manfredini, Roberto
通讯作者：
Manfredini, Roberto
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影响因子：
17.1
作者：
Chen K;Xu Z;Liu Y;Wang Z;Li Y;Xu X;Chen C;Xia T;Liao Q;Yao Y;Zeng C;He D;Yang Y;Tan T;Yi J;Zhou J;Zhu H;Ma J;Zeng C
通讯作者：
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影响因子：
3.3
作者：
DELCROIX, M;MELOT, C;NAEIJE, R
通讯作者：
NAEIJE, R
影响因子：
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作者：
MILLER, GAH;SUTTON, GC;HONEY, M
通讯作者：
HONEY, M
影响因子：
2.9
作者：
Manfredini, R;Gallerani, M;Mehta, RH
通讯作者：
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