Risicofactoren voor pulmonale hypertensie bij linkszijdig hartlijden
Bij 411 oudere mannelijke patiënten met linkszijdig hartlijden bleken atriumfibrilleren, linkeratriumdilatatie en een verlaagde linkerventrikelejectiefractie onafhankelijke voorspellers van pulmonale hypertensie.
Adequate behandeling van deze comorbiditeiten is essentieel voor het management van PH.
Abstract (original)
Pulmonary hypertension (PH) is an important reason for morbidity and mortality in patients with left heart disease (LHD). LHD is one the most common cause of PH in the elderly. Few studies have reported risk factors in patients with PH accompanied with LHD. To identify associated risk factors with PH in patients with LHD in elderly. A total of 411 aged male patients (>60 years) with LHDs were enrolled in this trail. Pulmonary artery systolic pressure (PASP), heart chamber diameters, and left ventricular functions were evaluated by transthoracic echocardiography. Patients were classified as PH group (n = 211) and non-PH group (n = 200) according to their PASP. Clinical history was collected from medical recordings. Independent associated factors for PH were identified by Logistic regression analysis. Compared with non-PHs, PH patients were more likely to have atrial fibrillation (AF; 21% vs 9.4%, P < .01), left atrial enlargement (39.25 ± 4.96 mm vs 36.94 ± 3.16 mm, P < .01), and reduced left ventricular ejection fraction (LVEF; 58.97 ± 6.51% vs 61.15 ± 4.72%, P < .01). Multivariate logistic regression analysis showed that AF, larger left atrial diameter, lower LVEF was independently associated with the presence of PH in patients with LHDs. In patients with PH, the PASP and left atrial diameter were all related to the number of co-morbidities (P < .05). AF, left atrial enlargement, and decreased LVEF are associated with the presence of PH in patients with LHDs. Well control of comorbidities and underlying heart diseases, prevention or treatment of AF may play key roles in the management of PH in patients with LHDs.
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Lees het volledige artikelDOI: 10.1097/MD.0000000000047799