心脏淀粉样变性患者三尖瓣环平面收缩期位移与肺动脉收缩压比值的预后价值。

IF 5.9 2区 医学 Q2 Medicine Revista espanola de cardiologia Pub Date : 2024-08-01 DOI:10.1016/j.recesp.2024.01.001
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引用次数: 0

摘要

导言和目的三尖瓣环平面收缩期偏移/收缩期肺动脉压(TAPSE/SPAP)比值是右心室至肺循环的无创替代指标,对心力衰竭(HF)或肺动脉高压患者的预后有影响。我们的目的是评估 TAPSE/SPAP 比值在心脏淀粉样变性患者中的预后价值。方法我们使用了 AMIGAL 研究的数据库,这是一项前瞻性、观察性的心脏淀粉样变性患者登记项目,从 2018 年 1 月 1 日至 2022 年 10 月 31 日在西班牙加利西亚自治区的 7 家医院招募。我们选择了通过经胸超声心动图计算基线TAPSE/SPAP比值的患者。我们通过 5 种不同的多变量 Cox 回归模型评估了患者的长期生存率和无高血压住院的生存率。中位随访时间为 680 天。结果我们共研究了 233 名心脏淀粉样变性患者,其中 209 人(89.7%)为转甲状腺素型。基线 TAPSE/SPAP 比值与临床结果有显著相关性。根据所考虑的多变量模型,基线 TAPSE/SPAP 比值每增加 0.1 mm/mmHg 所估计的全因死亡率调整危险比为 0.76 至 0.84。同样,心房颤动住院的全因死亡率的危险比在 0.79 到 0.84 之间。在英国国家淀粉样变性中心的预测模型中加入基线 TAPSE/SPAP 比值后,全因死亡率的 Harrell c 统计量从 0.662 增加到 0.705,全因死亡率或 HF 住院率的 Harrell c 统计量从 0.668 增加到 0.707。
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Valor pronóstico de la razón desplazamiento sistólico del plano del anillo tricuspídeo/presión arterial pulmonar sistólica en la amiloidosis cardiaca

Introduction and objectives

The tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/SPAP) ratio is a noninvasive surrogate of right ventricular to pulmonary circulation that has prognostic implications in patients with heart failure (HF) or pulmonary hypertension. Our purpose was to evaluate the prognostic value of the TAPSE/SPAP ratio in patients with cardiac amyloidosis.

Methods

We used the database of the AMIGAL study, a prospective, observational registry of patients with cardiac amyloidosis recruited in 7 hospitals of the Autonomous Community of Galicia, Spain, from January 1, 2018 to October 31, 2022. We selected patients whose baseline TAPSE/SPAP ratio was calculated with transthoracic echocardiography. Long-term survival and survival free of HF hospitalization were assessed by means of 5 different multivariable Cox regression models. Median follow-up was 680 days.

Results

We studied 233 patients with cardiac amyloidosis, among whom 209 (89.7%) had transthyretin type. The baseline TAPSE/SPAP ratio correlated significantly with clinical outcomes. Depending on the multivariable model considered, the adjusted hazard ratios estimated per 0.1 mm/mmHg increase of baseline TAPSE/SPAP ratio ranged from 0.76 to 0.84 for all-cause mortality. Similarly, the ratios for all-cause mortality of HF hospitalization ranged from 0.79 to 0.84. The addition of the baseline TAPSE/SPAP ratio to the predictive model of the United Kingdom National Amyloidosis Centre resulted in an increase in Harrell's c-statistic from 0.662 to 0.705 for all-cause mortality and from 0.668 to 0.707 for all-cause mortality or HF hospitalization.

Conclusions

Reduced TAPSE/SPAP ratio is an independent adverse prognostic marker in patients with cardiac amyloidosis.

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来源期刊
Revista espanola de cardiologia
Revista espanola de cardiologia 医学-心血管系统
CiteScore
4.20
自引率
13.60%
发文量
257
审稿时长
28 days
期刊介绍: Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.
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