右心房应变面积指数与肺动脉高压预后的关系  

R541Associations of right atrial strain-area index and prognosis of pulmonary arterial hypertension

作　　者：罗冬玲[1] 杨丽芳 黄陶然 费洪文[1] 张曹进[2] LUO Dong-ling;YANG Li-fang;HUANG Tao-ran;FEI Hong-wen;ZHANG Cao-jin(Department of Echocardiography,Guangdong Cardiovascular Institute,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所,广东省人民医院(广东省医学科学院),南方医科大学,心血管辅助诊断科,广东广州510080 [2]广东省心血管病研究所,广东省人民医院(广东省医学科学院),南方医科大学,心内科,广东广州510080

出　　处：《中国介入心脏病学杂志》2024年第12期670-675,共6页Chinese Journal of Interventional Cardiology

基　　金：广东省医学科学技术研究基金项目(B2023010)。

摘　　要：目的探讨右心房应变面积指数(RASAI),即右心房储备期应变与右心房面积比值,与肺动脉高压(PAH)预后的关系。方法纳入2021年10月至2023年4月期间在广东省人民医院接受治疗的91例PAH患者,测量右心房应变及右心房面积等常规超声参数,分析RASAI与PAH预后的关系。结果中位随访17(12,26)个月后,共发生19例不良结局。Cox回归分析结果显示,RASAI每升高1个单位,不良结局的发生风险降低40%(无矫正模型,HR0.60,95%CI0.40~0.91,P=0.016)。多变量矫正后,上述关系依然差异有统计学意义(HR 0.50,95%0.29~0.84,P=0.009)。三等分组结果及限制性立方样条法结果进一步证实了上述结果,RASAI与不良预后具有量效递减的关系。通过surv_cutpoint函数获得RASAI的最佳截断值为0.95。高RASAI(>0.95)组患者的预后显著优于低RASAI(≤0.95)组(多变量矫正模型,HR 0.21,95%CI 0.06~0.70,P=0.011)。结论RASAI与肺动脉高压的预后密切相关,有望成为疗效评估和预后预测的潜在指标。Objective To investigate the association between right atrial strain-area index(RASAI,the ratio of right atrial reservoir strain to right atrial area)and the prognosis of pulmonary arterial hypertension(PAH).Methods A total of 91 PAH patients who received treatment at Guangdong Provincial People’s Hospital from October 2021 to April 2023 were included.Echocardiographic parameters,including right atrial strain and right atrial area,were measured.The association between the RASAI and PAH prognosis was analyzed.Results After a median follow-up of 17(12,26)months,19 adverse events occurred.Cox regression analysis revealed that for per unit increase in RASAI,the risk of adverse outcomes decreased by 40%(unadjusted model,HR 0.60,95%CI 0.40–0.91,P=0.016).This association remained statistically significant after multivariable adjustment(HR 0.50,95%CI0.29–0.84,P=0.009).Results from tertile grouping and restricted cubic spline analysis further confi rmed that RASAI has a dose-response relationship with adverse prognosis.Patients in the high RASAI group had signifi cantly better prognosis than those in the low RASAI group(multivariable adjusted model,HR 0.21,95%CI 0.06-0.70,P=0.011).Conclusions The right atrial strain-area index is closely related to adverse prognosis and may serve as a potential indicator for therapeutic assessment and prognostic prediction.

关 键 词：右心房应变 右心房面积 肺动脉高压 预后 

分 类 号：R541[医药卫生—心血管疾病]