Right Ventricular Function Predicts Adverse Clinical Outcomes in Patients With Chronic Thromboembolic Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study.
Right Ventricular Function Predicts Adverse Clinical Outcomes in Patients With Chronic Thromboembolic Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study.
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DOI：
10.3389/fmed.2021.697396
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发表时间：
2021
影响因子：
3.9
通讯作者：
Lu X
中科院分区：
文献类型：
--
作者：
Li Y;Liang L;Guo D;Yang Y;Gong J;Zhang X;Zhang D;Jiang Z;Lu X
背景：右心室（RV）功能对慢性血栓栓塞性肺动脉高压（CTEPH）患者的预后起着至关重要的作用。我们使用新的基于机器学习（ML）的全自动软件，使用三维超声心动图（3DE）量化RV功能，以预测CTEPH患者的不良临床结果。方法：2015年4月至2019年7月，在这项前瞻性研究中，共有151名连续的CTEPH患者注册。采用新的基于ml的方法进行数据管理，并离线进行RV体积和射血分数（RVEF）的定量分析。用3DE法记录左心室结构和功能参数。采用右心导管诊断CTEPH， 62例患者行心脏磁共振评估右心功能。不良临床结果定义为与ph相关的咯血住院或RV衰竭增加，包括需要球囊肺血管成形术或肺动脉内膜切除术的情况，以及死亡。结果：中位随访时间为19.7个月（四分位数间0.5 ~ 54个月）。在151例CTEPH患者中，72例出现不良临床结果。多因素Cox比例风险分析显示，基于ml的RVEF 3DE分析是不良临床结局的预测因子(风险比1.576,95%可信区间（CI） 1.046~2.372；P = 0.030)。结论：新的基于ml的3DE算法是CTEPH患者RV功能快速三维量化的一种有前景的技术。
Background: Right ventricular (RV) function plays a vital role in the prognosis of patients with chronic thromboembolic pulmonary hypertension (CTEPH). We used new machine learning (ML)-based fully automated software to quantify RV function using three-dimensional echocardiography (3DE) to predict adverse clinical outcomes in CTEPH patients. Methods: A total of 151 consecutive CTEPH patients were registered in this prospective study between April 2015 and July 2019. New ML-based methods were used for data management, and quantitative analysis of RV volume and ejection fraction (RVEF) was performed offline. RV structural and functional parameters were recorded using 3DE. CTEPH was diagnosed using right heart catheterization, and 62 patients underwent cardiac magnetic resonance to assess right heart function. Adverse clinical outcomes were defined as PH-related hospitalization with hemoptysis or increased RV failure, including conditions requiring balloon pulmonary angioplasty or pulmonary endarterectomy, as well as death. Results: The median follow-up time was 19.7 months (interquartile range, 0.5–54 months). Among the 151 CTEPH patients, 72 experienced adverse clinical outcomes. Multivariate Cox proportional-hazard analysis showed that ML-based 3DE analysis of RVEF was a predictor of adverse clinical outcomes (hazard ratio, 1.576; 95% confidence interval (CI), 1.046~2.372; P = 0.030). Conclusions: The new ML-based 3DE algorithm is a promising technique for rapid 3D quantification of RV function in CTEPH patients.
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DOI：
10.1183/16000617.0112-2016
发表时间：
2017-03-31
期刊：
European respiratory review : an official journal of the European Respiratory Society
影响因子：
--
作者：
通讯作者：
--
影响因子：
37.8
作者：
Pepke-Zaba, Joanna;Delcroix, Marion;Simonneau, Gerald
通讯作者：
Simonneau, Gerald
DOI：
10.1016/j.echo.2019.04.001
发表时间：
2019-08-01
影响因子：
6.5
作者：
Genovese, Davide;Rashedi, Nina;Lang, Roberto M.
通讯作者：
Lang, Roberto M.
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
24.3
作者：
Ende-Verhaar, Yvonne M.;Cannegieter, Suzanne C.;Klok, Frederikus A.
通讯作者：
Klok, Frederikus A.