Nghiên cứu đặc điểm lâm sàng phân nhóm huyết động tăng áp phổi do bệnh tim trái trước mổ ở bệnh nhân thay van hai lá đơn thuần hoặc kết hợp

Abstract

Objective: We aimed at describing the different haemodynamic phenotypes of patients with pulmonary hypertension (PH) due to left heart disease (LHD) before mitral valve replacement and/or concomitant aortic valve replacement and at characterizing the impact of pulmonary haemodynamics on RV function. Subject and method: 67 patients with pulmonary hypertension related left heart diseases who underwent elective (MVR) and/or aortic valve replacement (AVR) enrolled in this prospective study from April, 2017 to April, 2018 at Hue Heart Center. Result and conclusion: Prevalence of three subgroups of patients PH: Isolated post-capillary PH (Ipc-PH), combined post- and pre-capillary PH (Cpc-PH), intermediate PH (Interm-PH) are 43.2%, 28.4% and 28.4%, respectively. CpcPH presented with slightly higher weight and body mass index than intermediate patients (p<0.05). There was a significant difference in PAPs, PAPd, PAPm, TPG, DPG, PVR, SV, CI parameters across the three subgroups of PH-LHD. TAPSE showed a significantly difference between groups, while the ratio between TAPSE and systolic PAP progressively decreased from IpcPH to “intermediate” PH-LHD to CpcPH (p<0.0001).