|
|
|
| The dinical value of p-wave dispersion in the diagnosis and prognosis of pulmonary arterial hypertension |
| SUN Jingjie1,2, LUO Peng1, MENG Taojiang3, LI Jiang1 |
1.Dept of Cardiology,Second Xiangya Hospital of Central South University;
2:Hainan Hospital of PLA General Hospital;
3:Sanya Rehabilitation Center of Joint Service Support Force |
|
|
|
|
Abstract Objective To explore the dinical value of p-wave dispersion (PWD) in thediagnosis and prognosis evduation of pulmonary arterial hypertension.Methods 103 cases of PAH patients and 30 healthy controls were collected. We measured the PWD of all personnel and collected indicators including blood biochemical indicators, echocardiography, and right-heart catheter hemodynamic parameters. So that we can analyze the change of PWD in each group and its correlation with various indicators. According to the risk assessment form recommended by the 2018 WSPH conference, the severity of PAH patients was divided into three groups: low, medium and high risk, therefore to compare the differences of PWD among the groups. We used ROC curve to evaluate the diagnostic efficacy of PWD on PAH.Results Significant increase in PWD in PAH group(P<0.001). PWD was significantly negatively correlated with mixed venous oxygen saturation and cardiac index (r values were -0.388, -0.331, P values are all <0.05). PWD was positively correlated with right atrial mean pressure and NT-proBNP (r values were 0.321, 0.636, P values are all <0.001).After the risk stratification of PAH patients, it was indicated that the groups of low, medium and high risk in PWD showed significant differences (43.89±9.91, 51.29±6.61, 62.15±10.44, P values are all <0.05), meanwhile there was a positive correlation between PWD and the quantitative value of PAH risk stratification(r=0.592,P<0.001).When PWD> 41.45ms, PWD has the highest sensitivity and specificity for predicting PAH, which are 85.44% and 86.67%, respectively.Conclusions PWD is significantly increased in patients with PAH, and it has a bearing on various indicators related to the diagnosis and prognosis of PAH, suggesting that PWD has certain clinical guiding significance for the diagnosis and prognosis evaluation of PAH patients.
|
|
Received: 10 March 2020
|
|
|
|
|
|
| [1] |
Humbert M,Guignabert C,Bonnet S,et al.Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives[J].Eur Respir J,2019,53(1):1-14.
|
| [2] |
Ren X,Johns R A, Gao W D.EXPRESS:Right Heart in Pulmonary Hypertension:From Adaptation to Failure[J].Pulm Circ,2019,9(3):1-20.
|
| [3] |
中华医学会心血管病学分会肺血管病学组,中华心血管病杂志编辑委员会.中国肺高血压诊断和治疗指南2018[J].中华心血管病杂志,2018,46(12):933-964.
|
| [4] |
Perez-Riera A R,de Abreu L C,Barbosa-barros R,et al.P-wave dispersion: an update.indian pacing electrophysiol[J].2016,16(4):126-133.
|
| [5] |
Galie N,Humbert M,Vachiery J L,et al.2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension:the Joint task force for the diagnosis and treatment of pulmonary hypertension of the european society of Cardiology (ESC) and the European respiratory society (ERS):Endorsed by:association for European paediatric and congenital cardiology(AEPC),International society for heart and lung transplantation (ISHLT)[J].Eur Respir J,2015,46(4):903-975.
|
| [6] |
Dilaveris P E,Gialafos E J,Sideris S K,et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation[J].Am Heart J,1998,135(5 Pt1):733-738.
|
| [7] |
Okutucu S,Aytemir K,Oto A.P-wave dispersion: what we know till now?[J].JRSM,2016,5:1-9.
|
| [8] |
Mercurio V,Peloquin G,Bourji K I,et al.Pulmonary arterial hypertension and atrial arrhythmias:incidence,risk factors,and clinical impact[J]. Pulm Circ,2018,8(2):1-8.
|
| [9] |
Ece I,Uner A,Balli M B,et al.P-wave and QT interval dispersion analysis in children with Eisenmenger syndrome[J].Arch Turk Soc Cardiol,2014,42(2):154-160.
|
| [10] |
Saleh Asmaa,Shabana Ahmed,El Amrousy Doaa,et al.Predictive value of P-wave and QT interval dispersion in children with congenital heart disease and pulmonary arterial hypertension for the occurrence of arrhythmias[J].J Saudi Heart Association,2019,31(2):57-63.
|
| [11] |
Ho T F,Chia E,Yip W,et al.Analysis of P-wave and P dispersion in children with secundumatrial septal defect[J].Ann Noninvasive Electrocardiol,2001,6(4):305-309.
|
| [12] |
Cimen A O,Emet S.An easy method for monitoring patients with pulmonary hypertension: P-wave dispersion[J].Cardio J Africa,2019,30:1-6.
|
| [13] |
Chetan V,Hampole,Amit K,et al.Usefulness of red cell distribution width as a prognostic marker in pulmonary hypertension[J]. Am J Cardio,2009,104(6):868-872.
|
| [14] |
Dhaun N,Vachiery J L,Benza R L,et al.Endothelin antagonism and uric acid levels in pulmonary arterial hypertension:clinical associations[J].Heart Lung Transplant,2014,33(5):521-527.
|
| [15] |
Iannuzzi Gian Luca,D’Alto Michele,Formisano Roberto,et al. Biomarkers in clinical management of pulmonary hypertension: has the emperor no clothes? A call for action[J].Biomarkers in medicine,2019,13(4):235-238.
|
| [16] |
曾晓春,黄丽蓉,伍伟锋.成人特发性肺动脉高压患者临床特点及预后分析[J].临床心血管病杂志,2018,34(1):42-47.
|
| [17] |
Uk K T,Park K Y,Kim H J,et al.Association of hyperuricemia and pulmonary hypertension: a systematic review and meta-analysis[J].Modern Rheumatol,2019,29(6):1031-1041.
|
| [18] |
Benza R L,Miller D P,Gomberg-Maitland M,et al.Predicting siurvival in pulmonary arterial hypertension:insights from the registry to evaluate early and long-term pulmonary arterial hypertension disease management(REVEAL) [J].Circulation,2010,122(2):164-172.
|
| [19] |
McLaughin W,Gaine S P,Howard L S,et al.Treatment goals of pulmonary hypertension[J].Am CollCardiol,2013,62(25 Suppl):D73-81.
|
| [1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(6): 547-548. |
|
|
|
|
2020, Vol. 31 
