慢性阻塞性肺疾病和系统性硬化症相关间质性肺疾病患者保留射血分数的心力衰竭特征

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Lyazat Ibrayeva, Meruyert Aubakirova, Irina Bacheva, Assel Alina, Nazira Bazarova, Aizhan Zhanabayeva, Olga Avdiyenko, Seda Borchashvili, Saltanat Tazhikhanova, Askhat Murzabaeyev
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引用次数: 0

摘要

背景/目的:本研究旨在探讨慢性阻塞性肺疾病(COPD)和系统性硬化症相关间质性肺疾病(SS-ILDs)患者发生HFpEF的潜在发病机制,并确定HFpEF可能存在的不同表型。它可以帮助临床医生改善HFpEF的早期个性化检测和管理。方法:本研究纳入150例慢性肺部疾病(CLDs)患者,如COPD和SS-ILD,非加重期,无慢性心力衰竭(CHF)病史,左心室射血分数(LV EF)≥50%。评估肺、心脏、内皮功能障碍和酸碱平衡的功能状态。根据保留射血分数(HFpEF)的HF存在与否,对CLD患者组的结果进行比较。HFpEF的诊断依据HFA-PEFF评分分级建立。采用非参数统计方法。结果:CLD患者年龄、右心房纵向大小、中部心房钠素前肽(MR-proANP)、高敏感心肌肌钙蛋白T (hsTnT)等指标均高于非HFpEF组。在COPD和HFpEF患者中,发现左心房容积有统计学意义的变化。在SS-ILD和HFpEF患者中,6分钟步行试验(6MWT)前后的收缩压、6MWT前的Borg评分、MR-proANP和右心房纵向尺寸均有统计学差异。结论:我们的研究结果使我们能够确定HFpEF发展的两种不同机制:在COPD患者中,HFpEF发展的主要因素是缺氧,而在SS-ILD患者中,继发性肺动脉高压背景下心肌功能障碍伴重构发展,突出了表型特异性评估的重要性。这些发现提示了针对HFpEF患者进行个性化风险分层和制定有针对性的管理策略的潜在方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of Heart Failure with Preserved Ejection Fraction in Patients with Chronic Obstructive Pulmonary Disease and Systemic Sclerosis-Associated Interstitial Lung Diseases.

Background/Objectives: This study aims to investigate the potential etiopathogenesis of HFpEF development and identify possible different phenotypes of HFpEF in patients with chronic obstructive pulmonary disease (COPD) and systemic sclerosis-associated interstitial lung diseases (SS-ILDs). It could help clinicians improve early HFpEF personalized detection and management. Methods: This study included 150 patients with chronic lung diseases (CLDs), such as COPD and SS-ILD, who were outside of exacerbation, had no history of chronic heart failure (CHF), and had a left ventricular ejection fraction (LV EF) of ≥50%. The functional status of the lungs, heart, endothelial dysfunction, and acid-base balance was assessed. The results obtained were compared in groups of patients with CLD depending on the presence or absence of HF with preserved ejection fraction (HFpEF). The diagnosis of HFpEF was established based on the HFA-PEFF Score classification. Nonparametric statistical methods were used. Results: In patients with CLD, indicators such as age, longitudinal size of the right atrium, mid-regional pro-atrial natriuretic peptide (MR-proANP), and highly sensitive cardiac troponin T (hsTnT) were higher than in the group of patients without HFpEF. In patients with COPD and HFpEF, statistically significant changes were found in the volume of the left atrium. In patients with SS-ILD and HFpEF, statistically significant differenceswere found in SBP before and after the 6 min walk test (6MWT), the Borg scale before 6MWT, MR-proANP, and the longitudinal dimension of the right atrium. Conclusions: The results of our study allow us to identify two different mechanisms of HFpEF development: In patients with COPD, the predominant factor in the development of HFpEF was hypoxia, while in patients with SS-ILD, myocardial dysfunction with remodeling developed against the background of secondary pulmonary hypertension, highlighting the importance of phenotype-specific evaluation. These findings suggest potential approaches for personalized risk stratification and the development of targeted management strategies for patients with HFpEF.

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来源期刊
Journal of Personalized Medicine
Journal of Personalized Medicine Medicine-Medicine (miscellaneous)
CiteScore
4.10
自引率
0.00%
发文量
1878
审稿时长
11 weeks
期刊介绍: Journal of Personalized Medicine (JPM; ISSN 2075-4426) is an international, open access journal aimed at bringing all aspects of personalized medicine to one platform. JPM publishes cutting edge, innovative preclinical and translational scientific research and technologies related to personalized medicine (e.g., pharmacogenomics/proteomics, systems biology). JPM recognizes that personalized medicine—the assessment of genetic, environmental and host factors that cause variability of individuals—is a challenging, transdisciplinary topic that requires discussions from a range of experts. For a comprehensive perspective of personalized medicine, JPM aims to integrate expertise from the molecular and translational sciences, therapeutics and diagnostics, as well as discussions of regulatory, social, ethical and policy aspects. We provide a forum to bring together academic and clinical researchers, biotechnology, diagnostic and pharmaceutical companies, health professionals, regulatory and ethical experts, and government and regulatory authorities.
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