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首页> 外文期刊>Pulmonary Circulation >Prognostic Utility of Right Atrial Emptying Fractions in Pulmonary Arterial Hypertension:
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Prognostic Utility of Right Atrial Emptying Fractions in Pulmonary Arterial Hypertension:

机译：右心房排空分数在肺动脉高压中的预后作用：

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Although left atrial function has been extensively studied in patients with heart failure, the determinants and clinical correlates of impaired right atrial (RA) function have been poorly studied. We investigated measures of RA function in pulmonary arterial hypertension (PAH). We identified all treatment-naive patients with World Health Organization category 1 PAH seen at our center during 2000–2011 who had right heart catheterization and 6-minute walk test (6MWT) within 1 month of initial echocardiographic examination. Atrial size was measured using the monoplane area-length method, and atrial function was quantified using total, passive, and active RA emptying fractions (RAEFs). We compared measures of RAEF with known prognostic clinical, echocardiographic, and hemodynamic parameters. For the subset of patients with follow-up echocardiographic examination/6MWT within 6–18 months, we investigated the change in RAEF. In an exploratory analysis, we investigated the association between RAEF and mortality. Our population consisted of 39 patients with treatment-naive (incident) PAH, 30 of whom had follow-up testing. The mean total, passive, and active RAEFs were 24.4% ± 15.1%, 8.5% ± 6.9%, and 17.6% ± 13.9%, respectively. Total and active RAEFs correlated with tricuspid annular plane systolic excursion (P = 0.004 and P = 0.005) and cardiac output (P = 0.02 and P = 0.01). The change in active RAEF correlated with change in 6-minute walk distance (P = 0.02). In our Cox regression analysis, low active and total RAEF were associated with mortality, with hazard ratios of 5.6 (95% confidence interval [CI], 1.2–26.2; P = 0.03) and 4.2 (95% CI, 1.1–15.5; P = 0.03), respectively. Passive RAEF was poorly reproducible and not associated with outcome. Measures of RAEF appear to have prognostic importance in PAH and warrant further study.
机译：尽管已经对心力衰竭患者的左心房功能进行了广泛的研究，但对右心房功能受损的决定因素和临床相关性研究却很少。我们调查了肺动脉高压（PAH）中RA功能的测量。我们确定了2000-2011年在我们中心发现的所有未经治疗的世界卫生组织第1类PAH患者，这些患者在初次超声心动图检查后的1个月内接受了右心导管检查和6分钟步行测试（6MWT）。使用单平面面积长度法测量心房大小，并使用总，被动和主动RA排空分数（RAEF）量化心房功能。我们将RAEF的测量值与已知的预后临床，超声心动图和血流动力学参数进行了比较。对于6-18个月内接受超声心动图检查/ 6MWT的患者亚组，我们调查了RAEF的变化。在探索性分析中，我们调查了RAEF与死亡率之间的关系。我们的人群包括39例未接受过治疗（事件）的PAH患者，其中30例接受了随访检查。平均总RAEF，被动RAEF和主动RAEF分别为24.4％±15.1％，8.5％±6.9％和17.6％±13.9％。总的和活动的RAEF与三尖瓣环平面收缩期偏移（P = 0.004和P = 0.005）和心输出量（P = 0.02和P = 0.01）相关。活动RAEF的变化与6分钟步行距离的变化相关（P = 0.02）。在我们的Cox回归分析中，低活跃度和总RAEF与死亡率相关，危险比分别为5.6（95％置信区间[CI]，1.2-26.2; P = 0.03）和4.2（95％CI，1.1-15.5; P） = 0.03）。被动RAEF的重现性较差，与结果无关。 RAEF的测定在PAH中似乎具有预后重要性，值得进一步研究。

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