Relationship Between Reactive Pulmonary Hypertension and Mortality in Patients With Acute Decompensated Heart Failure
Relationship Between Reactive Pulmonary Hypertension and Mortality in Patients With Acute Decompensated Heart Failure
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DOI：
10.1161/circheartfailure.110.960864
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发表时间：
2011-09-01
影响因子：
9.7
通讯作者：
Burger, Andrew J.
中科院分区：
文献类型：
--
作者：
Aronson, Doron;Eitan, Amnon;Burger, Andrew J.
心力衰竭患者肺动脉高压（PH）预示着较高的发病率和死亡率风险。然而，很少有数据可用于预后的影响反应性（毛细血管前）PH叠加被动（毛细血管后）PH。方法和结果，我们进行了一个亚组分析的242例急性失代偿性心力衰竭患者分配到肺动脉导管放置在血管舒张的管理急性充血性心力衰竭试验。使用最终（治疗后）血流动力学测量结果将患者分为3组：（1）无PH（平均肺动脉压25，肺毛细血管楔压>15 mm Hg，肺血管阻力=3 Wood nits）;和（3）反应性PH（平均肺动脉压15 mm Hg，肺血管阻力>3 Wood单位）。平均肺动脉压正常者58例，被动性肺动脉高压者124例，反应性肺动脉高压者60例。随访6个月，无肺动脉高压者5例（8.6%），被动性肺动脉高压者27例（21.8%），反应性肺动脉高压者29例（48.3%）死亡（P
Background-In patients with heart failure, pulmonary hypertension (PH) predicts higher risk for morbidity and mortality. However, few data are available on the prognostic implications of reactive (precapillary) PH superimposed on passive (postcapillary) PH.Methods and Results-We performed a subgroup analysis of 242 patients with acute decompensated heart failure assigned to pulmonary artery catheter placement in the Vasodilation in the Management of Acute Congestive Heart Failure trial. Patients were classified into 3 groups, using the final (posttreatment) hemodynamic measurements: (1) no PH (mean pulmonary artery pressure 25, pulmonary capillary wedge pressure >15 mm Hg, and pulmonary vascular resistance=3 Wood nits); and (3) reactive PH (mean pulmonary artery pressure 15 mm Hg, and pulmonary vascular resistance >3 Wood units). Fifty-eight patients were classified as normal mean pulmonary artery pressure, 124 with passive PH and 60 with reactive PH. During follow-up of 6 months, 5 (8.6%), 27 (21.8%), and 29 (48.3%) deaths occurred in patients without PH, patients with passive PH, and with reactive PH, respectively (P