摘要
目的右心室功能是影响肺动脉高压患者预后的重要因素。本研究通过心脏磁共振成像及右心导管检查,评估急性伊洛前列素吸入对肺动脉高压患者右心室功能的即刻影响。方法选择2015年9月—2017年12月肺动脉高压患者43例,其中特发性肺动脉高压患者23例,结缔组织病相关性肺动脉高压患者20例。患者均在基线状态和吸入伊洛前列素5μg,20 min后行右心导管及心脏磁共振成像检查。结果急性伊洛前列素吸入使肺血管阻力从(12±7)Wood降低到(9±5)Wood单位,右室射血分数从(30±11)%增加到(35±12)%(P<0.05),右室搏出量从(53±21)mL增加到(57±22)mL(P<0.05),舒张末期右室容积从(179±67)mL减少到(172±69)mL(P<0.05)。在特发性肺动脉高压患者中,急性伊洛前列素吸入诱导的右室射血分数改善程度与肺血管阻力降低程度相关(P<0.0001)。结论急性伊洛前列素吸入改善了特发性肺动脉高压和结缔组织疾病相关性肺动脉高压患者的右室射血分数、右室搏出量,减少了舒张末期右室容积。在特发性肺动脉高压患者中,右室射血分数增加与肺血管阻力的减少成正比。
Objective Right ventricle function is among the most important prognostic factors for pulmonary arterial hypertension(PAH)patients.The aim of this study is to investigate acute right ventricle response to inhalation of aerosolized iloprost in patients with PAH using CMRI.Methods This study involved 43 incident PAH patients,including 23 idiopathic PAH(IPAH)patients,20 patients with PAH associated with connective tissue disease(CTD-PAH).All patients underwent both right heart catheterization and CMRI at baseline and 20 min after 5μg iloprost inhalation.Results Acute iloprost inhalation reduced pulmonary vascular resistance(PVR)from(12±7)Wood U to(9±5)Wood U(P<0.05),increased right ventricle ejection fraction(RVEF)from(30±11)%to(35±12)%(P<0.05),increased right ventricle stroke volume from(53±21)mL to(57±22)mL(P<0.05)and decreased right ventricle end-diastolic volume from(179±67)mL to(172±69)mL(P<0.05).Acute iloprost inhalation-induced RVEF improvement was correlated with the degree of PVR reduction(P<0.0001)in IPAH patients,but not in CTD-PAH patients.Conclusion Acute iloprost inhalation improved RVEF,right ventricle stroke volume and decreased right ventricle volume in IPAH and CTD-PAH patients.Iloprost-induced RVEF increase was proportional to PVR reduction in IPAH patients,but not in CTD-PAH patients.
作者
段宇
贾静
步睿
李涛
韦宏
DUAN Yu;JIA Jing;BU Rui;LI Tao;WEI Hong(The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang,China)
出处
《心血管病学进展》
CAS
2019年第9期1319-1322,共4页
Advances in Cardiovascular Diseases
基金
哈尔滨医科大学创新基金(2017LCZX113)
黑龙江省卫生计生委科研课题(2018068)
关键词
伊洛前列素
右心室功能
肺动脉高压
心脏磁共振成像
Iloprost
Right ventricle function
Pulmonary arterial hypertension
Cardiovascular magnetic resonance imaging
