PAH 与继发性 PH 的 HFrEF 中的右心室心力衰竭：血液动力学、测力和器官功能相关性。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2024-09-01 DOI:10.1016/j.advms.2024.08.003

Katarzyna Krajewska, Krystian Ejdys, Klaudia Jadczak, Anna Lisowska, Karol A. Kamiński, Bożena Sobkowicz, Katarzyna Ptaszyńska

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引用次数: 0

摘要

目的：本研究的目的是确定日常使用的器官功能标记物，这些标记物可能有助于全面评估肺动脉高压（PAH）导致的右心室心力衰竭和左心室心力衰竭患者的心血管系统。我们分析了右心导管检查（RHC）参数、心肺运动测试（CPET）参数以及甲状腺、肝脏、肾脏功能和铁平衡的部分实验室参数之间的相关性：回顾性分析纳入 107 名患者（平均年龄为 57.6±16.2；34.6% 为女性），其中包括 57 名 PAH 患者（平均年龄为 54.0±18.2；49.1% 为女性）和 50 名射血分数降低的心力衰竭患者（HFrEF）：CPET 和实验室参数分析表明，在无继发性 PH 的 HFrEF 组和 HFrEF-SPH 组中，通气/二氧化碳产生（VE/VCO2）斜率与 NT-proBNP 之间存在很强的相关性。在 PAH 组中，VE/VCO2 斜率与肝脏和甲状腺功能相关，但也与红细胞系统的形态学参数相关。实验室和血液动力学参数之间的相关性分析表明，肺动脉压、肺血管阻力（PVR）和红细胞参数之间存在显著相关性，尤其是在 PAH 组中与 fT4 的相关性更强：HFrEF-SPH患者的实验室参数与肺动脉压和肺毛细血管楔压（PCWP）密切相关。

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Right-ventricle heart failure in PAH vs. HFrEF with secondary PH: Hemodynamic, ergospirometric, and organ function correlations

Purpose

The goal of the study was to identify markers of organ function used in daily routines that could potentially aid in the overall evaluation of the cardiovascular system in patients with right-ventricle heart failure due to pulmonary arterial hypertension (PAH) and left-ventricle heart failure. We analyzed correlations between parameters from right heart catheterization (RHC), cardiopulmonary exercise test (CPET), and selected laboratory parameters of thyroid, liver, kidneys function and iron homeostasis.

Patients and methods

A retrospective analysis included 107 patients (mean age 57.6 ± 16.2; 34.6 % women), comprising 57 patients with PAH (mean age 54.0 ± 18.2; 49.1 % women) and 50 patients with heart failure with reduced ejection fraction (HFrEF) < 40 % (mean age 61.6 ± 12.7; 18 % women). All patients underwent CPET. Each patient in the PAH group had RHC performed. Fifteen patients from the HFrEF group underwent RHC, which confirmed the suspicion of pulmonary hypertension (HFrEF-SPH).

Results

CPET and laboratory parameters’ analysis showed strong correlations between ventilation/carbon dioxide production (VE/VCO₂) slope and NT-proBNP in HFrEF without secondary PH and HFrEF-SPH groups. In the PAH group, VE/VCO₂ slope correlated with liver and thyroid function but also with morphological parameters of red-cell system.

Analysis of correlations between laboratory and hemodynamic parameters revealed significant correlations between pulmonary arterial pressure, pulmonary vascular resistance (PVR) and red-cell parameters, especially strong with fT4 in the PAH group.

Conclusions

In HFrEF-SPH patients, laboratory parameters strongly correlated with pulmonary pressures and pulmonary capillary wedge pressure (PCWP).

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.