Determinants of right ventricular ejection fraction in pulmonary arterial hypertension.
Determinants of right ventricular ejection fraction in pulmonary arterial hypertension.
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作者：
Kawut SM;Al-Naamani N;Agerstrand C;Berman Rosenzweig E;Rowan C;Barst RJ;Bergmann S;Horn EM
右心室功能是肺动脉高压（PAH）患者运动能力和生存的关键决定因素。我们的目的是研究新诊断PAH患者右心室射血分数（RVEF）的预测因素。我们对特发性、家族性或厌食相关PAH患者进行了回顾性横断面分析，这些患者接受了平衡放射性核素血管造影，以测量基线时的RVEF。在队列中的84例患者中，63例接受了平衡放射性核素血管造影和右心导管插入术，并被纳入。平均年龄41±13岁，女性占79%。平均RVEF为30±8%。RVEF与右心室卒中容积指数和心脏指数直接相关，与右心导管术后肺血管阻力指数负相关（均p < 0.001）。在调整肺血管阻力指数和左心室射血分数后，年龄和男性与RVEF降低相关（p < 0.05）。较高的血浆血管性血友病因子水平也与较低的RVEF独立相关（p = 0.01） （n = 55）。体型和多环芳烃类型与RVEF无关。即使在控制左心室功能和血流动力学之后，老年PAH患者和男性在基线时的RVEF也低于年轻患者和女性。较高的血浆血管性血友病因子水平（内皮功能障碍的标志）也与较低的RVEF相关。
Right ventricular function is a key determinant of exercise capacity and survival in pulmonary arterial hypertension (PAH). We aimed to study the predictors of right ventricular ejection fraction (RVEF) in patients with newly diagnosed PAH. We performed a cross-sectional analysis of a retrospective cohort of consecutive patients with idiopathic, familial, or anorexigen-associated PAH who underwent equilibrium radionuclide angiography for measurement of RVEF at baseline. Of the 84 patients in the cohort, 63 underwent equilibrium radionuclide angiography and right heart catheterization and were included. The mean age was 41 ± 13 years, and 79% of the patients were female. The mean RVEF was 30 ± 8%. RVEF was directly associated with right ventricular stroke volume index and cardiac index, and inversely associated with pulmonary vascular resistance index from right heart catheterization (all p < 0.001). Older age and male sex were associated with lower RVEF (p < 0.05) after adjustment for pulmonary vascular resistance index and left ventricular ejection fraction. Higher plasma von Willebrand factor levels were also independently associated with lower RVEF (p = 0.01) (n = 55). Body size and type of PAH were not associated with RVEF. Older patients and males with PAH had lower RVEF at baseline than younger patients and females, even after controlling for left ventricular function and hemodynamics. Higher plasma von Willebrand factor levels, a marker of endothelial dysfunction, were also associated with lower RVEF.
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影响因子：
2.8
作者：
DEMARIA, R;GAVAZZI, A;CAMERINI, F
通讯作者：
CAMERINI, F
DOI：
10.1016/s0735-1097(98)00347-7
发表时间：
1998-10-01
影响因子：
24
作者：
Douglas, PS;Katz, SE;Lorell, BH
通讯作者：
Lorell, BH
影响因子：
3.2
作者：
Kawut, Steven M.;Horn, Evelyn M.;Barst, Robyn J.
通讯作者：
Barst, Robyn J.
影响因子：
4.8
作者：
Mahmoodzadeh, Shokoufeh;Eder, Sarah;Regitz-Zagrosek, Vera
通讯作者：
Regitz-Zagrosek, Vera
影响因子：
9.6
作者：
McLaughlin, VV;Presberg, KW;Ahearn, G
通讯作者：
Ahearn, G