Survival in Sarcoidosis-Associated Pulmonary Hypertension The Importance of Hemodynamic Evaluation
Survival in Sarcoidosis-Associated Pulmonary Hypertension The Importance of Hemodynamic Evaluation
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DOI：
10.1378/chest.09-2002
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发表时间：
2010-11-01
期刊：
影响因子：
9.6
通讯作者：
Lower, Elyse E.
中科院分区：
文献类型：
--
作者：
Baughman, Robert P.;Engel, Peter J.;Lower, Elyse E.
目的：肺动脉高压（PH）与晚期肺结节病患者死亡率增加相关。结节病相关的 PH 可能是左心室功能障碍 (LVD) 或孤立性肺血管系统异常的结果。我们的目的是确定 PH 的原因是否会影响伴有持续性呼吸困难的结节病患者的生存。方法：尽管接受免疫抑制治疗但仍出现持续性呼吸困难的结节病患者接受了右侧心导管检查。肺动脉闭塞压 (PAO) >= 15 mm Hg 的患者被定义为患有 LVD。根据血流动力学将患者分类为无 PH（肺、动脉平均压 [PAmean] = 25 mm Hg，PAO = 25 mm Hg 且 PAO >= 15 mm Hg）。结果：在一个机构对 130 名患者进行了研究：50 名 (38.5%) 患者患有 PH，但不伴有 LVD，而 20 名 (15.4%) 患者患有 PH/LVD。所有患者在分析前至少 18 个月进行了诊断程序。无 LVD 的 PH 与无 PH 的死亡风险比 (HR) 为 10.39（95% CI，2.99-13.78；P
Objective: Pulmonary hypertension (PH) has been associated with increased mortality in patients with advanced pulmonary sarcoidosis. Sarcoidosis-associated PH may be the result of left ventricular dysfunction (LVD) or isolated pulmonary vasculature abnormality. Our objective was to determine if the cause of PH affects survival in patients with sarcoidosis with persistent dyspnea.Methods: Patients with sarcoidosis with persistent dyspnea despite immunosuppressive therapy underwent right-sided heart catheterization. Patients with a pulmonary artery occluding pressure (PAO) >= 15 mm Hg were defined as having LVD. Patients were classified based on hemodynamics as no PH (pulmonary, artery mean pressure [PAmean] = 25 mm Hg and PAO = 25 mm Hg and PAO >= 15 mm Hg).Results: One hundred thirty patients were studied at one institution: 50 (38.5%) patients had PH without LVD, whereas 20 (15.4%) had PH/LVD. All patients had their diagnostic procedure at least 18 months prior to analysis. The hazard ratio (HR) for death in PH without LVD vs no PH was 10.39 (95% CI, 2.99-13.78; P