CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement Meta-Analysis of Comparison of 5-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Unprotected Left Main Coronary Artery in the Era of Drug-eluting Stents Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Regurgitant Volume/Left Ventricular End-Diastolic Volume Ratio: Prognostic Value in Patients With Secondary Mitral Regurgitation Defining a new standard for IVUS optimized drug eluting stent implantation: the PRAVIO study Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Long-term results after PCI of unprotected distal left main coronary artery stenosis: the Bifurcations Bad Krozingen (BBK)-Left Main Registry

Original Research2021 Feb 2. doi: 10.1007/s10554-020-02128-5.

JOURNAL:Int J Cardiovasc Imaging . Article Link

A prediction model of simple echocardiographic variables to screen for potentially correctable shunts in adult patients with pulmonary arterial hypertension associated with atrial septal defects: a cross-sectional study

MQ Li, Y Wang, HW Fei et al. Keywords: ASD-PAH; PAH; screening

ABSTRACT

During the routine follow-up of adult patients with pulmonary arterial hypertension associated with atrial septal defects (ASD-PAH), the suitability of shunt closure depends on the invasive right heart catheterization (RHC). It is difficult to grasp the timing of RHC shunt closure for moderate-severe PAH. This retrospective cross-sectional study was designed to investigate which echocardiographic variables are related to pulmonary vascular resistance (PVR) in adult ASD-PAH patients and propose a method using echocardiographic variables to screen for patients where shunt closure is suitable. A total of 139 adult ASD-PAH patients with a PASP ≥ 60 mmHg measured by transthoracic echocardiogram (TTE) were included in this study. All RHCs were performed within a week after TTE. The Correctable shunt was defined as PVR ≤ 4.6 wood units (WU). Multivariate regressions were performed with echocardiographic variables. The nomogram of prediction model was constructed by the predictors of PVR ≤ 4.6 WU by multivariate logistic regression analysis. Multivariate linear regression revealed that TAPSE (tricuspid annular plane systolic excursion)/pulmonary artery systolic pressure (PASP) measured by TTE was negatively associated with PVR (β per SD: - 1.84, 95%CI - 2.62, - 1.06). Multivariate logistic regression showed that TAPSE/PASP and pulmonary valve (PV) peak velocity were positively associated with a potentially correctable shunt (PVR ≤ 4.6 WU) (OR per SD: 2.38, 95%CI 1.34, 4.25, and OR per SD: 2.67, 95%CI 1.26, 5.64, respectively). In receiver operating characteristic analysis, the TAPSE/PASP + PV peak velocity combined model achieved the best performance (AUC: 0.8584, sensitivity: 83.33%, specificity: 72.16%). Internal verification showed stable performance (AUC: 0.8591, sensitivity: 88.10%, specificity: 68.04%). The net benefit of this model was greater than other models when it came to a wide range probability threshold in decision curve analysis. TAPSE/PASP + PV the peak velocity model may have great value in predicting adult ASD-PAH patients with operability potential, which could help clinicians make the treatment decision for follow-up patients.

Keywords: Atrial septal defect; Echocardiograph