Identification of New Prognostic Factors of Pulmonary Hypertension
Identification of New Prognostic Factors of Pulmonary Hypertension
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DOI：
10.1253/circj.cj-10-0270
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发表时间：
2010-09-01
影响因子：
3.3
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
--
作者：
Miura, Yutaka;Fukumoto, Yoshihiro;Shimokawa, Hiroaki
背景：肺动脉高压(PH)仍然是一种严重的疾病，血浆脑利钠肽(BNP)水平和血流动力学指标(如心脏指数CL)是确定预后的因素。本研究的目的是寻找新的预后因素，以改善对PH的管理。方法与结果：本研究队列包括1974~2008年间收治的136例PH患者，在53.5+/-4.5个月的随访期内，每隔6-12个月密切随访一次。47例患者死于心肺疾病，经单一治疗后肺血流动力学改善，经多因素分析显示BNP和CI是影响PH患者预后的重要独立因素。然而，在确诊时低CI的PH患者中，只有PH治疗后的CI改善才是一个显著且独立的预后因素，确诊时低CI(CI=2.5)的患者与未经治疗正常者相比，生存率显著提高。结论：治疗后CL正常化是确诊时低CI患者PH的一个独立的新预后因素，提示加强治疗以实现CI正常化的重要性(Circ J 2010，74：1965-1971)。
Background: Pulmonary hypertension (PH) still remains a serious disease, for which the plasma level of brain natriuretic peptide (BNP) and hemodynamic variables (eg, cardiac index Cl) are established prognostic factors The aim of the present study was to identify new additional prognostic factors of the disorder to improve the management of PHMethods and Results: The study cohort comprised 136 consecutive PH patients admitted to hospital from 1974 to 2008, all of whom were closely followed every 6-12 months During the follow-up period of 53 5 +/- 4 5 [SEM] months, 47 patients died of cardiopulmonary causes The patients who were initially treated with monotherapy showed improved pulmonary hemodynamics when subsequently treated with combination therapy Multivariate analysis showed that BNP and Cl were significant and independent prognostic factors in all PH patients. However, in PH patients with low Cl at diagnosis, only Cl improvement by PH therapy was a significant and independent prognostic factor Indeed, the patients with low CI at diagnosis (Cl = 2.5) showed a significantly better survival compared with those without such normalizationConclusions: Cl normalization in response to treatment is an independent new prognostic factor of PH in patients with low Cl at diagnosis, suggesting the importance of intensive therapy to achieve Cl normalization (Circ J 2010, 74: 1965-1971)