医学
心脏病学
内科学
心房颤动
射血分数保留的心力衰竭
肺动脉高压
舒张期
心力衰竭
糖尿病
体质指数
射血分数
血压
内分泌学
作者
Emmanuelle Berthelot,David Montani,Vincent Algalarrondo,Céline Dreyfuss,R. Rifai,Anouar Benmalek,Xavier Jaïs,Amir Bouchachi,Laurent Savale,Gérald Simonneau,D. S. Chemla,Marc Humbert,Olivier Sitbon,Patrick Assayag
标识
DOI:10.1016/j.cardfail.2016.10.002
摘要
Background Heart failure with preserved ejection fraction (HFpEF) is a frequent cause of pulmonary hypertension (PH) that is not easy to differentiate from precapillary PH. We aimed to determine whether the characteristic features of the patients may help differentiate between HFpEF and precapillary PH. Methods and results Clinical and echocardiographic parameters were analyzed in 156 patients referred to our PH referral center. Right heart catheterization identified 78 PH-HFpEF patients and 78 with precapillary PH. Compared with precapillary PH, PH-HFpEF patients were older, with a smaller proportion of women, a higher proportion of hypertension, diabetes mellitus, atrial fibrillation and sleep apnea syndrome, and a higher body mass index. On echocardiography, PH-HFpEF patients had higher left ventricular mass index, higher left atrial area, and smaller right ventricular end-diastolic area. Following multivariate analysis, a model predicting the probability of PH-HFpEF was built with history of diabetes mellitus, presence of atrial fibrillation, left atrial area, right ventricular end-diastolic area, and left ventricular mass index. The score was internally validated using bootstrap method (area under the curve 0.93 [95% confidence interval 0.918–0.938]). A score <5 ruled out PH-HFpEF. Conclusion A score including clinical and echocardiographic criteria may help physicians to identify PH-HFpEF from precapillary PH.
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