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首页> 外文期刊>International Journal of Cardiology >Prognostic relevance of pulmonary arterial compliance after therapy initiation or escalation in patients with pulmonary arterial hypertension
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Prognostic relevance of pulmonary arterial compliance after therapy initiation or escalation in patients with pulmonary arterial hypertension

机译：肺动脉高血压患者治疗开始或升级后肺动脉顺应性的预后相关性

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Background: Conventional hemodynamic parameters are considered to be the gold standard indices of outcome in pulmonary arterial hypertension (PAH); on the contrary, few data support the hypothesis that the pulsatile component of right ventricular afterload provides important prognostic information. The aim of the study was to investigate the prognostic significance of pulmonary arterial compliance (PCa) after therapy initiation or escalation in PAH patients. Methods: A cohort of 419 consecutive PAH patients (308 naive and 111 prevalent) underwent right heart catheterisation (RHC) prior to initiating or escalating PAH-targeted therapy. RHC was repeated in 255 patients (61%) after 4 to 12 months of therapy as 62 patients (15%) died and 102 (24%) did not undergo a follow-up RHC within the first year. Results: After the follow-up RHC, 63 patients died over a median follow-up period of 39 months. At multivariate analysis, age N 50 years old, male gender, etiology associated with systemic sclerosis, persistence of WHO class III/ IV, and reduced PCa at follow-up RHC were the independent parameters significantly associated with poor prognosis. At ROC analysis, the optimal cut-off point of PCa to predict survival was 1.4 mL/mmHg (AUC 0.73, sensitivity 81.8%, specificity 58.8%). Conclusions: In PAH patients hospitalized to initiate or to escalate PAH-specific therapy, failure to improve PCa after therapy is a strong hemodynamic predictor of poor prognosis
机译：背景：常规血液动力学参数被认为是肺动脉高压（PAH）中的结果的黄金标准指标;相反，很少有数据支持右心室后载的脉动分量提供重要的预后信息。该研究的目的是探讨肺动脉顺应性（PCA）在PAH患者治疗后的肺动脉顺应性（PCA）的预后意义。方法：在启动或升级PAH靶向治疗之前，419个连续的PAH患者（308幼稚和111次普遍存在）接受右心导管（RHC）的队列。在4至12个月的治疗后，在255名患者（61％）中重复RHC（61％），因为62名患者（15％）死亡，102名（24％）在第一年内没有进行后续RHC。结果：后续RHC后，63名患者死于39个月的中位随访时间。在多变量分析中，年龄Ñ年龄50岁，男性，系统性硬化相关的病因学，WHO类III / IV，和减少前列腺癌的持久性在随访RHC是与预后不良相关联显著独立参数。在ROC分析中，PCA预测存活的最佳截止点为1.4ml / mmHg（AUC 0.73，灵敏度81.8％，特异性58.8％）。结论：在住院的PAH患者中促进或升级PAH特异性治疗，治疗后未能改善PCA是一种强烈的预后血液动力学预测因子

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