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摘要: 肺动脉高压是各种原因引起的肺动脉压力异常增高的一种病理生理状态,确诊时往往已处于疾病晚期,治疗棘手,预后不良。负荷超声心动图可以揭示负荷状态下的肺循环血流动力学的改变和功能状态,在肺动脉高压的早期筛查、诊断以及预后评估上可能具有重要意义。Abstract: Pulmonary hypertension is a pathophysiological state with abnormally increased pulmonary artery pressure due to various causes, and it is usually diagnosed in the advanced stage, leading to intractable treatment and poor prognosis. Stress echocardiography reveals the changes of hemodynamics and functional status of pulmonary circulation in stress, and it may play a crucial role in early screening, diagnosis and prognostic assessment of pulmonary hypertension.
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Key words:
- stress /
- echocardiography /
- pulmonary hypertension
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[1] 王辰,翟振国,杨媛华,等.肺动脉高压的概念与临床分类[M]//王辰.肺动脉高压.北京:人民卫生出版社,2014:1-8.
[2] GRUNIG E,WEISSMANN S,EHLKEN N,et al.Stress doppler echocardiography in relatives of patients with idiopathic and familial pulmonary arterial hypertension:results of a multicenter european analysis of pulmonary artery pressure response to exercise and hypoxia[J].Circulation,2009,119:1747-1757.
[3] LAU E M T,MANES A,CELERMAJER D S,et al.Early detection of pulmonary vascular disease in pulmonary arterial hypertension:time to move forward[J].Eur Heart J,2011,32:2489-2498.
[4] GALIÉN,HUMBERT M,VACHIERY J,et al.2015ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension[J].Eur Respir J,2015,46:903-975.
[5] 陈琳,杨树森.负荷超声心动图结合超声新技术诊断心肌缺血的研究进展[J].临床超声医学杂志,2015,17(7):473-475.
[6] ARMSTRONG W F.Stress echocardiography:introduction,history,and methods[J].Prog Cardiovasc Dis,1997,39:499-522.
[7] PICANO E,ALAIMO A,CHUBUCHNY V,et al.Noninvasive pacemaker stress echocardiography for diagnosis of coronary artery disease:a multicenter study[J].J Am Coll Cardiol,2002,40:1305-1310.
[8] HIRANO Y,OZASA Y,YAMAMOTO T,et al.Diagnosis of vasospastic angina by hyperventilation and cold-pressor stress echocardiography:Comparison to 123I-MIBG myocardial scintigraphy[J].J Am Soc Echocardiogr,2002,15:617-623.
[9] SENIOR R,LAHIRI A.Enhanced detection of myocardial ischemia by stress dobutamine echocardiography utilizing the"biphasic"response of wall thickening during low and high dose dobutamine infusion[J].J Am Coll Cardiol,1995,26:26-32.
[10] AFRIDI I,GRAYBURN P A,PANZA J A,et al.Myocardial viability during dobutamine echocardiography predicts survival in patients with coronary artery disease and severe left ventricular systolic dysfunction[J].J Am Coll Cardiol,1998,32:921-926.
[11] MAGNE J,LANCELLOTTI P,PIÉRARD L A.Exercise-induced changes in degenerative mitral regurgitation[J].J Am Coll Cardiol,2010,56:300-309.
[12] LANCELLOTTI P,MAGNE J,PIÉRARD L A.The role of stress testing in evaluation of asymptomatic patients with aortic stenosis.[J].Curr Opin Cardiol,2013,28:531-539.
[13] BRUN H,MOLLER T,FREDRIKSEN P M,et al.Mechanisms of exercise-induced pulmonary hypertension in patients with cardiac septal defects.[J].Pediatr Cardiol,2012,33:782-790.
[14] BACH D S.Stress echocardiography for evaluation of hemodynamics:valvular heart disease,prosthetic valve function,and pulmonary hypertension[J].Prog Cardiovasc Dis,1997,39:543-554.
[15] 丁云川,陈明,尹帆,等.负荷超声心动图评估右室容量负荷过重患者的右室收缩功能及肺动脉压力变化[J].中国超声诊断杂志,2003,4(12):904-906.
[16] 范志清,刘大一.负荷超声心动图检测隐性肺动脉高压一例[J].中国全科医学,2011,17(6):1983-1984.
[17] GALIE N,RUBIN L,HOEPER M,et al.Treatment of patients with mildly symptomatic pulmonary arterial hypertension with bosentan(EARLY study):a double-blind,randomised controlled trial[J].Lancet,2008,371:2093-2100.
[18] LAU E M T,VANDERPOOL R R,CHOUDHARYP,et al.Dobutamine stress echocardiography for the assessment of pressure-flow relationships of the pulmonary circulation.[J].Chest,2014,146:959-966.
[19] KUSUNOSE K,YAMADA H,HOTCHI J,et al.Prediction of Future Overt Pulmonary Hypertension by 6-Min Walk Stress Echocardiography in Patients With Connective Tissue Disease[J].J Am Coll Cardiol,2015,66:376-384.
[20] CHIN K,MATHAI S C.Exercise echocardiography in connective tissue disease[J].J Am Coll Cardiol,2015,66:385-387.
[21] KUSUNOSE K,YAMADA H.Rest and exercise echocardiography for early detection of pulmonary hypertension[J].J Echocardiogr,2015,14:2-12.
[22] CHIA E M,LAU E M,XUAN W,et al.Exercise testing can unmask right ventricular dysfunction in systemic sclerosis patients with normal resting pulmonary artery pressure[J].Int J Cardiol,2016,204:179-186.
[23] CODULLO V,CAPORALI R,CUOMO G,et al.Stress Doppler echocardiography in systemic sclerosis:evidence for a role in the prediction of pulmonary hypertension[J].Arthritis Rheum,2013,65:2403-2411.
[24] COLLINS N,BASTIAN B,QUIQUEREE L,et al.Abnormal pulmonary vascular responses in patients registered with a systemic autoimmunity database:Pulmonary Hypertension Assessment and Screening Evaluation using stress echocardiography(PHASE-I)[J].Eur J Echocardiogr,2006,7:439-446.
[25] GABRIELS C,LANCELLOTTI P,VAN DE BRU-AENE A,et al.Clinical significance of dynamic pulmonary vascular resistance in two populations at risk of pulmonary arterial hypertension[J].Eur Heart JCardiovasc Imag,2015,16:564-570.
[26] LANGE S A,BRAUN M U,SCHOEN S P,et al.Latent pulmonary hypertension in atrial septal defect:Dynamic stress echocardiography reveals unapparent pulmonary hypertension and confirms rapid normalisation after ASD closure[J].Neth Heart J,2013,21:333-343.
[27] GROEPENHOFF H,OVERBEEK M J,MULÉM,et al.Exercise pathophysiology in patients with chronic mountain sickness exercise in chronic mountain sickness.[J].Chest,2012,142:877-884.
[28] PRATALI L,ALLEMANN Y,RIMOLDI S F,et al.RV contractility and exercise-induced pulmonary hypertension in chronic mountain sickness:a stress echocardiographic and tissue Doppler imaging study[J].JACC,Cardiovasc Imag,2013,6:1287-1297.
[29] TOLLE J J,WAXMAN A B,VAN HORN T L,et al.Exercise-induced pulmonary arterial hypertension[J].Circulation,2008,118:2183-2189.
[30] OUDIZ R J,RUBIN L J.Exercise-Induced pulmonary arterial hypertension[J].Circulation,2008,118:2120-2121.
[31] ARGIENTO P,CHESLER N,MULÉM,et al.Exercise stress echocardiography for the study of the pulmonary circulation[J].Eur Respir J,2010,35:1273-1278.
[32] ARGIENTO P,VANDERPOOL R R,MULÉM,et al.Exercise stress echocardiography of the pulmonary circulation:Limits of normal and sex differences[J].Chest,2012,142:1158-1165.
[33] NAEIJE R,VANDERPOOL R,DHAKAL B P,et al.Exercise-induced pulmonary hypertension[J].Am J Respir Crit Care Med,2013,187:576-583.
[34] VAN RIEL A C M J,DE BRUIN-BON R H A C,GERTSEN E C,et al.Simple stress echocardiography unmasks early pulmonary vascular disease in adult congenital heart disease[J].Int J Cardiol,2015,197:312-314.
[35] HERVE P,LAU E M,SITBON O,et al.Criteria for diagnosis of exercise pulmonary hypertension[J].Eur Respir J,2015,46:728-737.
[36] ANJAK A,LÓPEZ-CANDALES A,LOPEZ F R,et al.Objective measures of right ventricular function during exercise:results of a pilot study[J].Echocardiogr,2014,31:508-515.
[37] GRUNIG E,TIEDE H,ENYIMAYEW E O,et al.Assessment and prognostic relevance of right ventricular contractile reserve in patients with severe pulmonary hypertension[J].Circulation,2013,128:2005-2015.
[38] VONK-NOORDEGRAAF A,HADDAD F,CHIN KM,et al.Right heart adaptation to pulmonary arterial hypertension:physiology and pathobiology[J].J Am Coll Cardiol,2013,62:D22-D33.
[39] GUIHAIRE J,HADDAD F,NOLY P E,et al.Right ventricular reserve in a piglet model of chronic pulmonary hypertension[J].Eur Respir J,2015,45:709-717.
[40] SHARMA T,LAU E M T,CHOUDHARY P,et al.Dobutamine stress for evaluation of right ventricular reserve in pulmonary arterial hypertension.[J].Eur Respir J,2015,45:700-708.
[41] MIYAMOTO S,NAGAYA N,SATOH T,et al.Clinical correlates and prognostic significance of sixminute walk test in patients with primary pulmonary hypertension[J].Am J Respir Crit Care Med,2000,161:192-487.
[42] LEWIS G D,BOSSONE E,NAEIJE R,et al.Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases[J].Circulation,2013,128:1470-1479.
[43] BOSSONE E,D'ANDREA A,D'ALTO M,et al.Echocardiography in pulmonary arterial hypertension:from diagnosis to prognosis[J].J Am Soc Echocardiogr,2013,26:1-14.
[44] LOPES L R,LOUREIRO M J,MIRANDA R,et al.The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure[J].Cardiovasc Ultrasound,2008,6:51.
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