Stress Doppler echocardiography for identification of susceptibility to high altitude pulmonary edema
Stress Doppler echocardiography for identification of susceptibility to high altitude pulmonary edema
复制标题
DOI：
10.1016/s0735-1097(99)00633-6
复制
发表时间：
2000-03-15
影响因子：
24
通讯作者：
Bärtsch, P
中科院分区：
文献类型：
--
作者：
Grünig, E;Mereles, D;Bärtsch, P
目的 这项前瞻性单盲研究旨在定量无创肺动脉收缩压（PASP）对长时间急性缺氧和正常氧运动的反应。背景缺氧引起的肺动脉压力过度升高是高原肺水肿（HAPE）的关键因素。我们假设易患 HAPE (HAPE-S) 的受试者不仅对缺氧而且对运动也增加了肺动脉压力反应。 方法 在 9 名 HAPE-S 和 11 名对照受试者中，使用多普勒超声心动图在缺氧 45、90 和 240 分钟 (FiO(2) = 12%) 以及在含氧量正常的仰卧自行车运动期间估计 PASP。 结果 在对照中 组中，缺氧 90 分钟后平均 PASP 从 26 +/- 2 增加到 37 +/- 4 mm Hg (Delta PASP 10.3 +/- 2 mm Hg)，运动期间从 27 +/- 4 增加到 36 +/- 3 mm Hg (Delta PASP 8 +/- 2 mm Hg)。相比之下，所有 HAPE-S 受试者在缺氧期间（从 28 +/- 4 到 57 +/- 10 mm Hg，Delta PASP 28.7 +/- 6 mm Hg）和运动期间（从 28 +/- 4 到 55 +/- II mm Hg，Delta PASP 27 +/- 8 mm Hg）均显示出平均 PASP 比对照受试者显着增加（p = 0.002 与对照相比）。负荷超声心动图允许在工作频率低于 150 W 时使用 45 mm Hg 的 PASP 截止值在没有重叠的情况下区分各组。结论这些数据表明 HAPE-S 受试者不仅对缺氧而且对常氧条件下的仰卧自行车运动也可能有异常的肺血管反应。因此，仰卧自行车运动期间或缺氧 90 分钟后的多普勒超声心动图可能是有用的非侵入性筛查方法，用于识别易患 HAPE 的受试者。 (C) 2000 年由美国心脏病学会发布。
OBJECTIVE This prospective single-blinded study was performed to quantitate noninvasive pulmonary artery systolic pressure (PASP) responses to prolonged acute hypoxia and normoxic exercise.BACKGROUND Hypoxia-induced excessive rise in pulmonary artery pressure is a key factor in high-altitude pulmonary edema (HAPE). We hypothesized that subjects susceptible to HAPE (HAPE-S) have increased pulmonary artery pressure response not only to hypoxia but also to exercise.METHODS PASP was estimated at 45, 90 and 240 min of hypoxia (FiO(2) = 12%) and during supine bicycle exercise in normoxia using Doppler-echocardiography in nine HAPE-S and in 11 control subjects.RESULTS In the control group, mean PASP increased from 26 +/- 2 to 37 +/- 4 mm Hg (Delta PASP 10.3 +/- 2 mm Hg) after 90 min of hypoxia and from 27 +/- 4 to 36 +/- 3 mm Hg (Delta PASP 8 +/- 2 mm Hg) during exercise. In contrast, all HAPE-S subjects revealed significantly greater increases (p = 0.002 vs. controls) in mean PASP both during hypoxia (from 28 +/- 4 to 57 +/- 10 mm Hg, Delta PASP 28.7 +/- 6 mm Hg) and during exercise (from 28 +/- 4 to 55 +/- II mm Hg, Delta PASP 27 +/- 8 mm Hg) than did control subjects. Stress echocardiography allowed discrimination between groups without overlap using a cut off PASP value of 45 mm Hg at work rates less than 150 W.CONCLUSIONS These data indicate that HAPE-S subjects may have abnormal pulmonary vascular responses not only to hypoxia but also to supine bicycle exercise under normoxic conditions. Thus, Doppler echocardiography during supine bicycle exercise or after 90 min of hypoxia may be useful noninvasive screening methods to identify subjects susceptible to HAPE. (C) 2000 by the American College of Cardiology.