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首页> 外文期刊>Circulation journal >Clinical significance of reactive post-capillary pulmonary hypertension in patients with left heart disease
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Clinical significance of reactive post-capillary pulmonary hypertension in patients with left heart disease

机译：左心病患者反应性毛细血管后肺动脉高压的临床意义

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Background: Post-capillary pulmonary hypertension (pc-PH) is a disorder with elevated pulmonary arterial pressure and pulmonary vascular resistance (PVR) because of left heart disease (LHD), and is classified as reactive (PVR >2.5 WU) or passive (PVR ≤2.5 WU). However, the clinical significance of these pc-PH subtypes remains to be elucidated. Methods and Results: We examined 676 consecutive patients with chronic heart failure (CHF) (NYHA ≥2), and found that 158 (23%) had pc-PH: reactive pc-PH in 58 and passive pc-PH in 100. Univariate analysis showed that 4 factors were significantly associated with reactive pc-PH and multivariate analysis showed that female sex was the only independent predictor of reactive pc-PH (odds ratio 2.12, 95% confidence interval (CI) 1.05-4.30, P=0.03). During the mean follow-up period of 2.6 years, 125 CHF patients (18%) died, including 22 with reactive pc-PH and 24 with passive pc-PH (P<0.001). Multivariate Cox regression analysis showed that elevated PVR was independently associated with higher mortality (hazard ratio 1.18, 95%CI 1.03-1.35, P=0.02). Kaplan-Meier analysis demonstrated that the prognosis of patients with reactive pc-PH was significantly worse than for those with no PH or passive pc-PH. Reactive pc-PH was a significant prognostic factor regardless of CHF etiology (ischemic vs. non-ischemic) or reduced/preserved LV ejection fraction (HFrEF vs. HFpEF). Conclusions: Reactive pc-PH is characterized by predominant female sex and is a significant prognostic factor of LHD with PH.
机译：背景：毛细血管后肺动脉高压（pc-PH）是一种由于左心疾病（LHD）导致肺动脉压升高和肺血管阻力（PVR）的疾病，分为活动性（PVR> 2.5 WU）或被动性（ PVR≤2.5 WU）。但是，这些pc-PH亚型的临床意义仍有待阐明。方法和结果：我们检查了676例连续的慢性心力衰竭（CHF）（NYHA≥2）患者，发现158（23％）的患者有pc-PH：反应性pc-PH为58，被动性pc-PH为100。分析显示有4个因素与反应性pc-PH显着相关，多因素分析表明女性是反应性pc-PH的唯一独立预测因子（优势比2.12,95％置信区间（CI）1.05-4.30，P = 0.03） 。在平均2.6年的随访期间，有125例CHF患者死亡（18％），包括22例反应性pc-PH和24例被动性pc-PH（P <0.001）。多因素Cox回归分析显示，PVR升高与死亡率增加独立相关（危险比1.18，95％CI 1.03-1.35，P = 0.02）。 Kaplan-Meier分析表明，反应性pc-PH患者的预后显着低于无PH或被动性pc-PH的患者。无论是CHF病因（缺血性还是非缺血性）或左室射血分数降低/保留（HFrEF与HFpEF），反应性pc-PH都是重要的预后因素。结论：反应性pc-PH以女性为主，是LHD合并PH的重要预后因素。

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