Clinical and Prognostic Relevance of Echocardiographic Evaluation of Right Ventricular Geometry in Patients With Idiopathic Pulmonary Arterial Hypertension
Clinical and Prognostic Relevance of Echocardiographic Evaluation of Right Ventricular Geometry in Patients With Idiopathic Pulmonary Arterial Hypertension
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DOI：
10.1016/j.amjcard.2010.10.027
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发表时间：
2011-02-15
影响因子：
2.8
通讯作者：
Visconti, Luigi Oltrona
中科院分区：
文献类型：
--
作者：
Ghio, Stefano;Pazzano, Anna Sara;Visconti, Luigi Oltrona
本研究的目的是评价超声心动图显示的右室扩大和右室肥厚在特发性肺动脉高压患者中的临床和预后意义。对72例特发性肺动脉高压患者进行了超声心动图和右心导管术。中位随访期38个月。根据右室壁厚度的中位数(6.6 mm)和右室直径的中位数(36.5 mm)进行分组。在多因素分析中，平均肺动脉压(p=0.018)是右室壁厚度的唯一独立预测因素，年龄(p=0.011)和中至重度三尖瓣反流(p=0.027)是右室内径的独立预测因素。在随访期间，22名患者死亡。右室直径为36.5 mm的患者的死亡率高于右室直径为6.6 mm的患者，右室直径为36 mm的患者预后不差(p=0.6837)。总之，在特发性肺动脉高压患者中，较大的右室内径是预后不良的标志，但较大的右室壁厚降低了与右室扩张相关的死亡风险。(C)2011 Elsevier Inc.保留所有权利。(美国心脏杂志2011；107：628-632)
The aim of the present study was to assess the clinical and prognostic significance of right ventricular (RV) dilation and RV hypertrophy at echocardiography in patients with idiopathic pulmonary arterial hypertension. Echocardiography and right heart catheterization were performed in 72 consecutive patients with idiopathic pulmonary arterial hypertension admitted to our institution. The median follow-up period was 38 months. The patients were grouped according to the median value of RV wall thickness (6.6 mm) and the median value of the RV diameter (36.5 mm). On multivariate analysis, the mean pulmonary artery pressure (p = 0.018) was the only independent predictor of RV wall thickness, and age (p = 0.011) and moderate to severe tricuspid regurgitation (p = 0.027) were the independent predictors of RV diameter. During follow-up, 22 patients died. The death rate was greater in the patients with a RV diameter > 36.5 mm than in patients with a RV diameter 6.6 mm, a RV diameter > 36 mm was not associated with a poorer prognosis (p = 0.6837). In conclusion, in patients with idiopathic pulmonary arterial hypertension, a larger RV diameter is a marker of a poor prognosis but a greater RV wall thickness reduces the risk of death associated with a dilated right ventricle. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:628-632)