目的:本研究的目的是评估心电图(ECG)在预测慢性血栓栓塞性肺动脉高压(CTEPH)患者接受球囊肺动脉成形术(BPA)后血流动力学改善中的价值。
方法:共32例患者纳入研究。在心电图分析期间,评估了与右心室肥厚和/或扩张相关的参数.测试了在BPA前就诊和在BPA后6个月的预定对照就诊时获得的每个参数的变化的显著性。除了心电图分析,与右心导管插入术(RHC)和超声心动图相关的数据,记录所有患者的B型利钠肽(BNP)水平和世界卫生组织(WHO)功能分类。研究了心电参数可能变化量与血流动力学参数可能变化量的关系。
结果:丹尼尔得分,已被认为对急性肺栓塞有预后价值,BPA程序后从8.22±5.68降至6.56±5.55(p:0.035)。在所有研究的参数中,V2推导中只有T波高(V2t)从-0.77±2.39到1.27±2.58mm发生显着变化(p:0.036)。发现V2T的变化量与右心室收缩压的变化量显着相关,平均肺动脉压,肺血管阻力,和全身血管阻力。
结论:在接受BPA治疗的CTEPH患者中,V2导联术后T波变化可能是血流动力学改善的标志。
The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting postoperative hemodynamic improvement in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).
A total of 32 patients were included in the study. During ECG analysis, parameters that have been suggested to be related to right ventricular hypertrophy and/or dilatation were evaluated. The significance of the change in each parameter obtained at the pre-BPA visit and at the scheduled control visit 6 months after BPA was tested. In addition to ECG analysis, data related to right heart catheterization (RHC) and echocardiography, B-type natriuretic peptide (BNP) levels and World Health Organization (WHO) functional classifications of all patients were also recorded. The relationship between the amount of possible change in ECG parameters and the amount of possible change in hemodynamic parameters was investigated.
The Daniel score, which has been suggested to have prognostic value in acute pulmonary embolism, decreased from 8.22 ± 5.68 to 6.56 ± 5.55 after the BPA procedure (p: 0.035). Among all parameters studied, only T wave height (V2 t) in V2 derivation changed significantly from -0.77 ± 2.39 to 1.27 ± 2.58 mm (p: 0.036). The amount of change in V2 T was found to significantly correlate with the amount of change in systolic right ventricular pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and systemic vascular resistance.
Postprocedural T wave changes in lead V2 might serve as a marker of hemodynamic improvement in patients with CTEPH who undergo BPA.