基于肺活量和肺动脉收缩压的老年人肺动脉高压预测。

IF 1.5 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
JRSM Cardiovascular Disease Pub Date : 2020-11-12 eCollection Date: 2020-01-01 DOI:10.1177/2048004020973834
Simon Wernhart, Jürgen Hedderich
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引用次数: 2

摘要

目的:右心导管(RHC)与老年人较高的手术风险相关,但肺动脉高压(PH)的无创评估是一个挑战。我们的目的是建立一个无创预测模型来估计ph。方法和设计:我们回顾性分析了134名老年人(70.0岁±12.3岁;44.9%男性),在2015年1月至2020年1月期间报告有不明确的呼吸困难,并接受RHC作为诊断检查的一部分。RHC 24小时内进行肺功能检查、血气分析、6 min步行距离及超声心动图检查。主要结果测量:采用逐步统计方法,采用内/排除算法(使用AIC标准),我们分析了非侵入性参数,以检验其预测PH(定义为平均肺动脉压,PAmean, >25mmHg)的价值。最终模型的识别能力由ROC(受试者工作特征)分析得出的AUC(曲线下面积)来衡量。结果:肺动脉收缩压(sPAP)和肺活量(VCmax)联合logistic模型的敏感性为87.2%,特异性为62.5%,鉴别指数为86.7%。sPAP升高10 mmHg的比值比为2.99 (2.08-4.65),VCmax降低1 l的比值比为1.86(1.11-3.21)。VCmax是特异性的(83.3%),而sPAP是PH的敏感预测因子(79.1%)。结论:我们提供了一个组合模型来预测老年人sPAP和VCmax的PH,这可能有助于避免侵入性手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure.

Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure.

Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure.

Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure.

Objective: Right heart catheterization (RHC) is associated with a higher procedural risk in older adults, but non-invasive estimation of pulmonary hypertension (PH) is a challenge. We aimed to elaborate a non-invasive prediction model to estimate PH.

Methods and design: We retrospectively analysed 134 older adults (70.0 years ±12.3; 44.9% males) who reported to our clinic with unclear dyspnea between 01/2015 and 01/2020 and had received RHC as a part of their diagnostic workup. Lung function testing, analysis of blood gas samples, 6 min walk distance and echocardiography were performed within 24 hours of RHC.

Main outcome measures: In a stepwise statistical approach by using an in/exclusion algorithm (using the AIC criterion) we analysed non-invasive parameters to test their value in predicting PH (defined as mean pulmonary artery pressure, PAmean, >25mmHg). Discrimination capability of the final model was measured by the AUC (area under curve) from an ROC (receiver operating characteristics) analysis.

Results: We yielded a sensitivity of 87.2% and a specificity of 62.5% in a combinatorial logistical model with systolic pulmonary artery pressure (sPAP) and forced vital capacity (VCmax), the discrimination index was 86.7%. The odds ratios for an increase of 10 mmHg of sPAP were 2.99 (2.08-4.65) and 1.86 (1.11-3.21) for a 1 l decrease in VCmax. On their own, VCmax proved to be specific (83.3%), while sPAP was a sensitive (79.1%) predictor for PH.

Conclusions: We provide a combinatorial model to predict PH from sPAP and VCmax in older adults, which may help to avoid invasive procedures.

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来源期刊
JRSM Cardiovascular Disease
JRSM Cardiovascular Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
自引率
6.20%
发文量
12
审稿时长
12 weeks
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