Assessment of pulmonary hypertension in the pediatric catheterization laboratory: current insights from the Magic registry.
Assessment of pulmonary hypertension in the pediatric catheterization laboratory: current insights from the Magic registry.
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DOI：
10.1002/ccd.22693
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发表时间：
2010-11-15
影响因子：
2.3
通讯作者：
Moore, J. Donald
中科院分区：
文献类型：
--
作者：
Hill, Kevin D.;Lim, D. Scott;Everett, Allen D.;Ivy, D. Dunbar;Moore, J. Donald
评估因肺动脉高压（PH）接受导管插入术的儿科患者的方案、人口统计学和血流动力学。儿科特定数据仅限于PH.中大西洋介入心脏病组（MAGIC）协作PH登记数据集的审查。2003年11月至2008年10月期间，7家机构提交了177例疑似PH的儿科患者的初始导管插入数据。先天性心脏病相关肺动脉高压（APAH-CHD）（n = 61，34%）比特发性PAH（IPAH）（n = 36，20%）更常见。IPAH患者年龄大，平均肺动脉压（mPAP）高（P < 0.01）。氧分压降低IPAH患者mPAP（P < 0.01）和非先天性心脏病相关PAH（APAH-non CHD）患者mPAP（P < 0.01）。吸入一氧化氮（iNO）后有协同作用（P < 0.01）。总体而言，9/30（29%）例IPAH患者和8/48（16%）例APAH-非CHD患者对血管扩张剂试验有反应。氧分压降低APAH-CHD患者肺血管阻力指数（PVRI）（P < 0.01）。iNO没有累加效应，但一部分患者需要iNO将PVRI降至5 WU·m2以下。全身麻醉（GA）降低了全身动脉压（P < 0.01），但GA与程序镇静对mPAP或PVRI的影响无差异。不良事件罕见（n = 7），无手术死亡。与成人相比，患有PH的儿科患者表现出较高的APAH-CHD和新生儿特异性疾病的发生率。儿童PH患者可能表现出基线mPAP < 40 mm Hg but >50%全身说明成人标准应用于PH儿童的困难。PH儿童导管插入术相对安全。
To assess protocols, demographics, and hemodynamics in pediatric patients undergoing catheterization for pulmonary hypertension (PH). Pediatric specific data is limited on PH. Review of the Mid-Atlantic Group of Interventional Cardiology (MAGIC) collaboration PH registry dataset. Between November 2003 and October 2008, seven institutions submitted data from 177 initial catheterizations in pediatric patients with suspected PH. Pulmonary arterial hypertension associated with congenital heart disease (APAH-CHD) (n = 61, 34%) was more common than idiopathic PAH (IPAH) (n = 36, 20%). IPAH patients were older with higher mean pulmonary arterial pressures (mPAP) (P < 0.01). Oxygen lowered mPAP in patients with IPAH (P < 0.01) and associated PAH not related to congenital heart disease (APAH-non CHD) (P < 0.01). A synergistic effect was seen with inhaled Nitric Oxide (iNO) (P < 0.01). Overall 9/30 (29%) patients with IPAH and 8/48 (16%) patients with APAH-non CHD were reactive to vasodilator testing. Oxygen lowered pulmonary vascular resistance index (PVRI) in patients with APAH-CHD (P < 0.01). There was no additive effect with iNO but a subset of patients required iNO to lower PVRI below 5 WU·m2. General anesthesia (GA) lowered systemic arterial pressure (P < 0.01) with no difference between GA and procedural sedation on mPAP or PVRI. Adverse events were rare (n = 7) with no procedural deaths. Pediatric patients with PH demonstrate a higher incidence of APAH-CHD and neonatal specific disorders compared to adults. Pediatric PH patients may demonstrate baseline mPAP < 40 mm Hg but > 50% systemic illustrating the difficulty in applying adult criteria to children with PH. Catheterization in children with PH is relatively safe.
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影响因子：
2.8
作者：
GALIE, N;USSIA, G;MAGNANI, B
通讯作者：
MAGNANI, B
影响因子：
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作者：
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通讯作者：
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作者：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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