ABSTRACT
Objective To analyze and compare the changes of cardiac structure and function in patients with borderline pulmonary hypertension.Methods Echocardiographic data of 617 outpatients from February to October 2018 in Peking University People's Hospital were retrospectively analyzed.According to the estimated mean pulmonary artery pressure (mPAP),the patients were divided into normal group (mPAP<19 mmHg),borderline group(19 mmHg≤mPAP<25 mmHg)and elevated group(mPAP≥25 mmHg).Results ①Compared with normal group,the patients were older in borderline group and elevated group[(39.2±10.1)years old vs(46.5±13.5)years old vs(51.8±14.2)years old,all P <0.001]and the proportions of male were relatively lower(69.9％ vs 58.9％ vs 54.4％,all P <0.01).The incidences of smoking,drinking and cardiovascular complications increased significantly.②Compared with normal group, the left atrium[(30.2±8.2)ml/m2 vs(34.5±9.7)ml/m2,P <0.001],left ventricle[(57.4±11.6)ml/m2 vs(60.6±12.5)ml/m2,P <0.01]and right atrium[(19.5±5.9)ml/m2 vs(22.6±7.0)ml/m2,P<0.001] were enlarged in borderline group.Left ventricular global long-axis strain (GLSLV) increased [(-20.1±2.5)％ vs (-21.1 ±3.1)％,P <0.001],but the long-axis strain in the middle segment of right ventricular free wall(GLSRVFWmid)decreased[(-31.4±6.6)％ 对(-27.2±8.8)％,P <0.001]in borderline group.Meanwhile,left ventricular diastolic function was impaired.③Age,sex,right atrial volume,right ventricular area,RV-S',GLSLV ,GLSRVFW mid and mitral valve E/e' were independent risk factors for mPAP elevation.Conclusions Early changes of cardiac structure and function exist in the patients with borderline pulmonary hypertension.Echocardiography is critical for the early diagnosis andfollow-up monitoring of pulmonary hypertension.
ABSTRACT
Objective@#To analyze and compare the changes of cardiac structure and function in patients with borderline pulmonary hypertension.@*Methods@#Echocardiographic data of 617 outpatients from February to October 2018 in Peking University People′s Hospital were retrospectively analyzed. According to the estimated mean pulmonary artery pressure (mPAP), the patients were divided into normal group (mPAP<19 mmHg), borderline group (19 mmHg≤mPAP<25 mmHg) and elevated group (mPAP≥25 mmHg).@*Results@#①Compared with normal group，the patients were older in borderline group and elevated group[(39.2±10.1)years old vs (46.5±13.5)years old vs (51.8±14.2)years old，all P<0.001] and the proportions of male were relatively lower (69.9% vs 58.9% vs 54.4%，all P<0.01). The incidences of smoking，drinking and cardiovascular complications increased significantly. ②Compared with normal group，the left atrium[(30.2±8.2)ml/m2 vs (34.5±9.7)ml/m2，P<0.001]，left ventricle[(57.4±11.6)ml/m2 vs (60.6±12.5)ml/m2，P<0.01]and right atrium[(19.5±5.9)ml/m2 vs (22.6±7.0)ml/m2，P<0.001] were enlarged in borderline group.Left ventricular global long-axis strain (GLSLV) increased[(-20.1±2.5)% vs (-21.1±3.1)%，P<0.001]，but the long-axis strain in the middle segment of right ventricular free wall (GLSRVFWmid) decreased[(-31.4±6.6)%对(-27.2±8.8)%，P<0.001] in borderline group.Meanwhile，left ventricular diastolic function was impaired. ③Age，sex，right atrial volume，right ventricular area，RV-S′，GLSLV，GLSRVFWmid and mitral valve E/e′ were independent risk factors for mPAP elevation.@*Conclusions@#Early changes of cardiac structure and function exist in the patients with borderline pulmonary hypertension. Echocardiography is critical for the early diagnosis and follow-up monitoring of pulmonary hypertension.
ABSTRACT
Objective To analyze and compare the classification of left atrial size by different echocardiographic measurements based on the latest large sample of normal Chinese adults'echocardiographic data . Methods The echocardiography data of 1067 unselected adult outpatients were retrospectively analyzed . The outpatients were divided into normal or enlarged groups according to the left atrialantero-posteriordiameter(LAD)andleftatrialvolume(LAV),respectively.Results ①LADand LAV enlargement were found in 299 (28 .0％ ) patients and 449 (42 .1％ ) patients of the total population , respectively . ②There was a good positive linear correlation between LAD and LAV ( r = 0 .642 , P =0 .000) ,but the agreement for the classification of left atrial size by LAD and LAV was not ideal ( Kappa =0 .392 , P = 0 .000) . The majority of the patients ( 74 .6％ ) with abnormal LAD had abnormal LAV . Conversely ,among the patients with abnormal LAV ( 50 .3％ ) had normal LAD . ③ The sensitivity and specificity of judging left atrial enlargement were 76 .8％ and 66 .8％ for LAD>3 .7 cm in male ,and 74 .9％and 70 .6％ for LAD>3 .4 cm in female ,respectively . The sensitivity and specificity of judging severely left atrial enlargement were 75 .5％ and 78 .7％ for LAD>4 .0 cm in male ,and 84 .2％ and 75 .8％ for LAD>3 .7 cm in female ,respectively . Conclusions The agreement of the classification of left atrial size by LAD and LAV is limited . LAD-based assessment may result in an underestimation of left atrial size . When LAD is larger than 4 .0 cm for male or 3 .7 cm for female ,the accuracy of LAD in the diagnosis of left atrial enlargement is better .