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首页> 外文期刊>Pulmonary Circulation >Value of lung perfusion scintigraphy in patients with idiopathic pulmonary arterial hypertension: a patchy pattern to consider:
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Value of lung perfusion scintigraphy in patients with idiopathic pulmonary arterial hypertension: a patchy pattern to consider:

机译：肺灌注显像在原发性肺动脉高压患者中的价值：需要考虑的斑块模式：

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The ventilation/perfusion lung scan is recommended to exclude chronic thromboembolic pulmonary hypertension in the diagnostic algorithm of pulmonary hypertension, but its role in pulmonary arterial hypertension (PAH) has not been well explored. We characterized the lung perfusion pattern assessed by lung perfusion scintigraphy in idiopathic PAH (IPAH) patients and evaluate the potential prognostic significance of the patchy pattern perfusion defect. A total of 318 patients with IPAH confirmed by right heart catheterization who performed lung perfusion scintigraphy were included. On lung perfusion scintigraphy, 134 patients had normal lung perfusion and 184 patients showed patchy perfusion defects. In comparison to patients with normal lung perfusion, patients with patchy perfusion defects experienced significantly higher mean pulmonary arterial pressure (58.0?±?15.4?mmHg vs. 54.1?±?16.2?mmHg, P?=?0.027) and total pulmonary resistance (1192.6?±?533.7?dyn·s·cm?5 vs. 1067.2?±?549.3?dyn·s·cm?5, P?=?0.042). During a median follow-up period of 884.0 days, 53 patients reached the primary endpoint of all-cause mortality. On univariate Cox analysis, the patchy pattern of perfusion defect was significantly associated with the all-cause mortality (hazard ratio [HR]?=?2.47, 95% confidence interval [CI]?=?1.32–4.63, P?=?0.005). Patients with patchy perfusion defects had a worse outcome (log-rank?=?8.605, P?=?0.003). On multivariate analysis, the patchy pattern remained as a significant independent predictor of the endpoint (HR?=?2.30, 95% CI?=?1.22–4.31, P?=?0.010). IPAH patients presented with heterogeneity in lung perfusion and the patchy pattern of lung perfusion defect commonly existed. Patients with patchy pattern identified by lung perfusion scintigraphy were associated with more severe disease and worse outcome.
机译：在通气性肺动脉高压的诊断算法中，建议进行通气/灌注肺部扫描以排除慢性血栓栓塞性肺动脉高压，但尚未充分探讨其在肺动脉高压（PAH）中的作用。我们表征了肺灌注显像技术评估的特发性PAH（IPAH）患者的肺灌注模式，并评估了斑块模式灌注缺陷的潜在预后意义。包括总共318例经右心导管检查证实的IPAH患者，这些患者进行了肺灌注显像。肺灌注显像检查中，有134例肺灌注正常，有184例表现出斑片状灌注缺陷。与正常肺灌注的患者相比，具有局部灌注缺陷的患者的平均肺动脉压显着升高（58.0？±？15.4？mmHg与54.1？±？16.2？mmHg，P？=？0.027）和总肺阻力（ 1192.6±±533.7Δdyn·s·cm·5与1067.2±±549.3Δdyn·s·cm·5，P≤0.042。在884.0天的中位随访期内，有53例患者达到了全因死亡率的主要终点。在单因素Cox分析中，灌注缺陷的斑块模式与全因死亡率显着相关（危险比[HR]？=？2.47，95％置信区间[CI]？=？1.32-4.63，P？=？0.005 ）。斑片状灌注缺陷患者的预后较差（log-rank≥8.605，P≤0.003）。在多变量分析中，斑块模式仍然是终点的重要独立预测因子（HR == 2.30，95％CI == 1.22-4.31，P == 0.010）。 IPAH患者在肺灌注中表现出异质性，并且肺灌注缺损的斑块形式普遍存在。经肺灌注显像检查发现斑块状的患者与更严重的疾病和更差的预后相关。

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