Clinically Significant Change in Stroke Volume in Pulmonary Hypertension
Clinically Significant Change in Stroke Volume in Pulmonary Hypertension
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DOI：
10.1378/chest.10-1066
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发表时间：
2011-05-01
期刊：
影响因子：
9.6
通讯作者：
Noordegraaf, Anton Vonk
中科院分区：
文献类型：
--
作者：
van Wolferen, Serge A.;van de Veerdonk, Mariellie C.;Noordegraaf, Anton Vonk
背景：每搏输出量可能是最好的血流动力学参数，因为它反映了治疗的变化，并包含了肺动脉高压(PH)的预后信息。每搏输出量直接反映右室功能对其负荷的反应，而不像心输出量那样校正代偿性心率增加。因此，可以无创测量的每搏量是治疗过程中需要监测的重要血流动力学参数。然而，构成临床显著变化的每搏量变化的程度尚不清楚。本研究的目的是确定PH患者每搏输出量的最小重要差异(MID)。方法：对111例患者在基线和1年后进行6min步行试验(6MWT)和心脏MRI检查。结果：治疗1年后，平均每搏输出量和每搏输出量均有显著增加。每搏出血量的变化与6MWT的变化有关。使用基于锚点的方法，计算了10毫升的MID每搏输出量。基于分布的方法导致MID为8-12毫升。结论：两种方法都显示在随访期间每搏输出量变化10毫升应被认为是临床相关的。这个值可以用来解释PH患者临床随访期间每搏量的变化。2011年；139(5)：1003-1009
Background: Stroke volume is probably the best hemodynamic parameter because it reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular function in response to its load, without the correction of compensatory increased heart rate as is the case for cardiac output. For this reason, stroke volume, which can be measured noninvasively, is an important hemodynamic parameter to monitor during treatment. However, the extent of change in stroke volume that constitutes a clinically significant change is unknown. The aim of this study was to determine the minimal important difference (MID) in stroke volume in PH.Methods,: One hundred eleven patients were evaluated at baseline and after 1 year of follow-up with a 6-min walk test (6MWT) and cardiac MRI. Using the anchor-based method with 6MWT as the anchor, and the distribution-based method, the MID of stroke volume change could be determined.Results: After 1 year of treatment, there was, on average, a significant increase in stroke volume and 6MWT. The change in stroke volume was related to the change in 6MWT. Using the anchor-based method, an MID of 10 mL in stroke volume was calculated. The distribution-based method resulted in an MID of 8 to 12 mL.Conclusions: Both methods showed that a 10-mL change in stroke volume during follow-up should be considered as clinically relevant. This value can be used to interpret changes in stroke volume during clinical follow-up in PH. CHEST 2011;139(5):1003-1009