医学
动脉血
心脏病学
内科学
动脉血气分析
肺动脉高压
作者
Marius M. Hoeper,Mathias W. Pletz,Heiko Golpon,Tobias Welte
出处
期刊:The European respiratory journal
[European Respiratory Society]
日期:2007-05-01
卷期号:29 (5): 944-950
被引量:144
标识
DOI:10.1183/09031936.00134506
摘要
Blood gas abnormalities in patients with idiopathic pulmonary arterial hypertension (IPAH) may be related to disease severity and prognosis. The present authors performed a 12-yr retrospective analysis assessing arterialised capillary blood gases, haemodynamics, exercise variables and survival in 101 patients with IPAH. At baseline, arterial oxygen tension (P(a,O(2))) and carbon dioxide arterial tension (P(a,CO(2))) were 9.17+/-1.86 and 4.25+/-0.532 kPa, respectively. While P(a,O(2) )was not associated with survival, a low P(a,CO(2 ))was a strong and independent prognostic marker. When patients were divided according to a baseline P(a,CO(2 ))value above or below 4.25 kPa, a cut-off value determined by receiver operating characteristics analysis, survival rates were 98 and 86% at 1 yr, 82 and 69% at 2 years, 80 and 51% at 3 yrs, 77 and 41% at 5 yrs, and 65 and 12% at 8 yrs, respectively. P(a,CO(2 ))after 3 months of medical therapy was strongly associated with survival. Hypocapnia at rest and during exercise correlated with low cardiac output, low peak oxygen uptake and reduced ventilatory efficacy. Multiple regression analysis revealed that 6-min walking distance, right atrial pressure and P(a,CO(2 ))were independently associated with survival. In patients with idiopathic pulmonary arterial hypertension, hypocapnia (carbon dioxide arterial tension <4.25 kPa) is an independent marker of mortality.
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