冠状动脉窦在特发性肺动脉高压危险分层和预后评价中的作用。

IF 0.9 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Herz Pub Date : 2025-09-22 DOI:10.1007/s00059-025-05341-x

Begum Uygur, Kadriye Memiç Sancar, Ümit Bulut, Serkan Kahraman, Alkım Ateşli Yazıcı, Ali Rıza Demir, Hicaz Zencirkıran Ağuş, Gizemnur Coşkun, Mehmet Erturk, Mustafa Yıldız

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引用次数: 0

摘要

目的：冠状窦（CS）可以反映右心室的压力和容量负荷。特发性肺动脉高压（IPAH）是一种进行性、危及生命的疾病，其中风险评估起着至关重要的作用。我们的目的是评估(a) IPAH患者CS直径与风险评估参数之间的相关性，以及(b) CS直径在预测死亡率和住院率方面的效用。方法：对25例IPAH患者进行回顾性研究。所有患者均在同一天接受超声心动图和实验室检查、6分钟步行试验和心肺运动试验。随访16.8 ±10.1个月。主要终点是死亡率或住院率。分析CS直径、已建立的危险参数与预后的关系。结果：住院6例（24%），随访期间死亡3例（12%）。CS平均直径为9.9 ±3.7 mm，与年龄（r = 0.560,p = 0.004）、NT-proBNP水平（r = 0.625,p = 0.001）呈中度正相关；与功能类呈弱正相关（r = 0.483,p = 0.017）；与6分钟步行距离（r = -0.553,p = 0.005）和峰值摄氧量（r = -0.506,p = 0.038）呈中度负相关。CS直径越大，年龄越大，NT-proBNP水平越高，功能等级越差，而运动能力和峰值VO2的降低伴随着CS直径的增加。CS直径> 9 mm预测死亡率和住院率的敏感性为77.8%，特异性为75.0%（曲线下面积[AUC]: 0.788; 95% CI: 0.580-0.996; p = 0.019）。Kaplan-Meier曲线显示，随着CS直径的增加，死亡率和住院率显著增加。结论：CS直径是一种简单、容易获得、无创的超声心动图参数，可能是目前IPAH风险评估模型的一种有价值的辅助手段。

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Role of the coronary sinus in risk stratification and prognostic evaluation of idiopathic pulmonary arterial hypertension.

Objective: The coronary sinus (CS) can reflect the pressure and volume load of the right heart chambers. Idiopathic pulmonary arterial hypertension (IPAH) is a progressive, life-threatening disease in which risk assessment plays a critical role. We aimed to evaluate (a) the correlation between CS diameter and risk assessment parameters in IPAH patients and (b) the utility of CS diameter in predicting mortality and hospitalization.

Methods: This retrospective study included 25 IPAH patients. All patients underwent echocardiographic and laboratory examinations, 6‑minute walk test, and cardiopulmonary exercise test on the same day. The follow-up was 16.8 ± 10.1 months. The primary endpoint was mortality or hospitalization. The relationship between CS diameter, established risk parameters, and prognosis was analyzed.

Results: Six patients (24%) were hospitalized, and three patients (12%) died during the follow-up . The mean CS diameter was 9.9 ± 3.7 mm and showed a moderate positive correlation with age (r = 0.560, p = 0.004) and NT-proBNP levels (r = 0.625, p = 0.001); a weak positive correlation with functional class (r = 0.483, p = 0.017); and moderate negative correlations with 6‑min walking distance (r = -0.553, p = 0.005) and peak oxygen uptake (r = -0.506, p = 0.038). Greater CS diameter was associated with older age, higher NT-proBNP levels, and worse functional class, while reduced exercise capacity and peak VO₂ were accompanied by increased CS diameter. A CS diameter > 9 mm predicted mortality and hospitalization with a sensitivity of 77.8% and specificity of 75.0% (area under the curve [AUC]: 0.788; 95% CI: 0.580-0.996; p = 0.019). The Kaplan-Meier curve showed that as CS diameter increased, mortality and hospitalization rates increased significantly.

Conclusion: The CS diameter is a simple, readily available, noninvasive echocardiographic parameter that may be a valuable adjunct to current risk assessment models in IPAH.

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来源期刊

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.