A. Callegari, J. Grynblat, M. Mathilde, I. Szezepanski, S. Malekzadeh-Milani, D. Bonnet
{"title":"出生后头 12 个月的肺活量：我们应该期待什么？","authors":"A. Callegari, J. Grynblat, M. Mathilde, I. Szezepanski, S. Malekzadeh-Milani, D. Bonnet","doi":"10.1016/j.acvd.2024.07.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Mean pulmonary artery pressure (mPAP)<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg defines pulmonary hypertension (PH).</p></div><div><h3>Objective</h3><p>Critically evaluate this cut-off in very young patients.</p></div><div><h3>Methods</h3><p>In total, 1129 consecutive patients had a reliable mPAP measurement between 1–12<!--> <!-->months of life. These invasive measurements and their clinical history were reviewed.</p></div><div><h3>Results</h3><p>Age was mean<!--> <!-->±<!--> <!-->SD 158<!--> <!-->±<!--> <!-->100<!--> <!-->days, weight 5.5<!--> <!-->±<!--> <!-->1.9<!--> <!-->kg. Patients with a palliated single ventricle anatomy 129/1129, peripheral PA-branch stenosis or MAPCAs 45/1129, PA-banding for open shunt 30/1129, or severe RVOTO 185/1129 were excluded. Of the remaining 726 patients 163/726 (22%) had mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg while 563 (78%) had PH with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg.</p><p>Overall, PH at TTE was the reason for invasive mPAP measurement in 236 patients and only 16/236 patients (7%) had a mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg but 12/16 (75%) had a mPAP<!--> <!-->≥<!--> <!-->18<!--> <!-->mmHg. In the group with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg PH persisted at 6-months in 109/236 (46%) (<span><span>Fig. 1</span></span>A) and in 68/236 (28%) at long-term follow-up (<span><span>Fig. 1</span></span>B). In the group with mPAP between 18 and 20<!--> <!-->mmHg PH persisted at 6-months in 9/12 (75%) and in 3/12 (25%) at long-term follow-up. None of the patients with mPAP<!--> <!--><<!--> <!-->18<!--> <!-->mmHg had PH at follow-up.</p><p>In patients with less than 3<!--> <!-->months of age, PH at TTE was the reason for invasive mPAP measurement in 73/306 (23%) and only 3/73 patients (4%) had a mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg, but 2/3 (75%) had a mPAP<!--> <!-->≥<!--> <!-->18<!--> <!-->mmHg. In the group with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg PH persisted at 6-months in 34/70 (48%) (<span><span>Fig. 2</span></span>A) and in 34/70 (48%) at long-term follow-up (<span><span>Fig. 2</span></span>B). In the group with mPAP between 18 and 20<!--> <!-->mmHg PH persisted at 6-months in 2/2 (100%) and in 2/2 (100%) at long-term follow-up. None of those with mPAP<!--> <!--><<!--> <!-->18<!--> <!-->mmHg had PH at follow-up.</p></div><div><h3>Conclusion</h3><p>Pulmonary hypertension defined by mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg is very common in this cohort of young patients, especially in case of suspected PH at echo. A different cut-off defined as 18<!--> <!-->mmHg should be discussed in patients with less than 12-months.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pulmonary pressure in the first twelve-months of live: What should we expect?\",\"authors\":\"A. Callegari, J. Grynblat, M. Mathilde, I. Szezepanski, S. Malekzadeh-Milani, D. Bonnet\",\"doi\":\"10.1016/j.acvd.2024.07.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Mean pulmonary artery pressure (mPAP)<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg defines pulmonary hypertension (PH).</p></div><div><h3>Objective</h3><p>Critically evaluate this cut-off in very young patients.</p></div><div><h3>Methods</h3><p>In total, 1129 consecutive patients had a reliable mPAP measurement between 1–12<!--> <!-->months of life. These invasive measurements and their clinical history were reviewed.</p></div><div><h3>Results</h3><p>Age was mean<!--> <!-->±<!--> <!-->SD 158<!--> <!-->±<!--> <!-->100<!--> <!-->days, weight 5.5<!--> <!-->±<!--> <!-->1.9<!--> <!-->kg. Patients with a palliated single ventricle anatomy 129/1129, peripheral PA-branch stenosis or MAPCAs 45/1129, PA-banding for open shunt 30/1129, or severe RVOTO 185/1129 were excluded. Of the remaining 726 patients 163/726 (22%) had mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg while 563 (78%) had PH with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg.</p><p>Overall, PH at TTE was the reason for invasive mPAP measurement in 236 patients and only 16/236 patients (7%) had a mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg but 12/16 (75%) had a mPAP<!--> <!-->≥<!--> <!-->18<!--> <!-->mmHg. In the group with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg PH persisted at 6-months in 109/236 (46%) (<span><span>Fig. 1</span></span>A) and in 68/236 (28%) at long-term follow-up (<span><span>Fig. 1</span></span>B). In the group with mPAP between 18 and 20<!--> <!-->mmHg PH persisted at 6-months in 9/12 (75%) and in 3/12 (25%) at long-term follow-up. None of the patients with mPAP<!--> <!--><<!--> <!-->18<!--> <!-->mmHg had PH at follow-up.</p><p>In patients with less than 3<!--> <!-->months of age, PH at TTE was the reason for invasive mPAP measurement in 73/306 (23%) and only 3/73 patients (4%) had a mPAP<!--> <!--><<!--> <!-->20<!--> <!-->mmHg, but 2/3 (75%) had a mPAP<!--> <!-->≥<!--> <!-->18<!--> <!-->mmHg. In the group with mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg PH persisted at 6-months in 34/70 (48%) (<span><span>Fig. 2</span></span>A) and in 34/70 (48%) at long-term follow-up (<span><span>Fig. 2</span></span>B). In the group with mPAP between 18 and 20<!--> <!-->mmHg PH persisted at 6-months in 2/2 (100%) and in 2/2 (100%) at long-term follow-up. None of those with mPAP<!--> <!--><<!--> <!-->18<!--> <!-->mmHg had PH at follow-up.</p></div><div><h3>Conclusion</h3><p>Pulmonary hypertension defined by mPAP<!--> <!-->≥<!--> <!-->20<!--> <!-->mmHg is very common in this cohort of young patients, especially in case of suspected PH at echo. A different cut-off defined as 18<!--> <!-->mmHg should be discussed in patients with less than 12-months.</p></div>\",\"PeriodicalId\":55472,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1875213624002249\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1875213624002249","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Critically evaluate this cut-off in very young patients.
Methods
In total, 1129 consecutive patients had a reliable mPAP measurement between 1–12 months of life. These invasive measurements and their clinical history were reviewed.
Results
Age was mean ± SD 158 ± 100 days, weight 5.5 ± 1.9 kg. Patients with a palliated single ventricle anatomy 129/1129, peripheral PA-branch stenosis or MAPCAs 45/1129, PA-banding for open shunt 30/1129, or severe RVOTO 185/1129 were excluded. Of the remaining 726 patients 163/726 (22%) had mPAP < 20 mmHg while 563 (78%) had PH with mPAP ≥ 20 mmHg.
Overall, PH at TTE was the reason for invasive mPAP measurement in 236 patients and only 16/236 patients (7%) had a mPAP < 20 mmHg but 12/16 (75%) had a mPAP ≥ 18 mmHg. In the group with mPAP ≥ 20 mmHg PH persisted at 6-months in 109/236 (46%) (Fig. 1A) and in 68/236 (28%) at long-term follow-up (Fig. 1B). In the group with mPAP between 18 and 20 mmHg PH persisted at 6-months in 9/12 (75%) and in 3/12 (25%) at long-term follow-up. None of the patients with mPAP < 18 mmHg had PH at follow-up.
In patients with less than 3 months of age, PH at TTE was the reason for invasive mPAP measurement in 73/306 (23%) and only 3/73 patients (4%) had a mPAP < 20 mmHg, but 2/3 (75%) had a mPAP ≥ 18 mmHg. In the group with mPAP ≥ 20 mmHg PH persisted at 6-months in 34/70 (48%) (Fig. 2A) and in 34/70 (48%) at long-term follow-up (Fig. 2B). In the group with mPAP between 18 and 20 mmHg PH persisted at 6-months in 2/2 (100%) and in 2/2 (100%) at long-term follow-up. None of those with mPAP < 18 mmHg had PH at follow-up.
Conclusion
Pulmonary hypertension defined by mPAP ≥ 20 mmHg is very common in this cohort of young patients, especially in case of suspected PH at echo. A different cut-off defined as 18 mmHg should be discussed in patients with less than 12-months.
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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