TY - T1的肺部动脉内膜切除术后持续运动不耐受CTEPH JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00109 -2020欧元SP - 2000109 AU Ruigrok Dieuwertje AU - Meijboom,莉莲J . AU - Nossent以斯帖J . AU - Boonstra Anco盟——Braams纳塔莉亚J . AU - van Wezenbeek,杰西盟德曼,弗朗西丝·s . AU -马库斯,J·蒂姆AU - Vonk Noordegraaf,安东AU - Symersky,切赫盟——Bogaard摘要N2 - Aim血流动力学正常化是肺内膜切除术(PEA)治疗慢性血栓栓塞性肺动脉高压(CTEPH)的最终目标。然而，血流动力学的正常是否能转化为运动能力的正常尚不清楚。PEA后运动不耐受的发病率、决定因素和临床意义尚不清楚。我们进行了前瞻性分析，以确定PEA后运动不耐受的发生率，评估运动能力和(静息)血流动力学之间的关系，并寻找PEA后运动不耐受的术前预测因素。方法根据临床协议所有患者接受心肺运动试验(CPET),右心catheterisation (RHC)和心脏磁共振成像(CMR)之前和豌豆后6个月。运动不耐受被定义为预测的峰值VO2<80%。通过CPET参数判断运动受限的原因。分析了运动不耐受与静息血流动力学和cmr衍生的右心室(RV)功能的关系。使用logistic回归分析术前运动不耐受的潜在预测因素。结果最终纳入68例患者。45例(66%)患者在PEA 6个月后出现运动不耐受; in 20 patients this was primarily caused by a cardiovascular limitation. The incidence of residual PH was significantly higher in patients with persistent exercise intolerance (p 0.001). However, 27 out of 45 patients with persistent exercise intolerance had no residual PH. In the multivariate analysis, preoperative transfer factor for carbon monoxide (TLCO) was the only predictor of exercise intolerance after PEA.Conclusions The majority of CTEPH patients has exercise intolerance after PEA, often despite normalisation of resting hemodynamics. Not all exercise intolerance after PEA is explained by the presence of residual PH, and lower preoperative TLCO was a strong predictor of exercise intolerance 6 months after PEA.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ruigrok has nothing to disclose.Conflict of interest: Dr. Meijboom has nothing to disclose.Conflict of interest: Dr. Nossent has nothing to disclose.Conflict of interest: Dr. Boonstra has nothing to disclose.Conflict of interest: Dr. Braams has nothing to disclose.Conflict of interest: Dr. van Wezenbeek has nothing to disclose.Conflict of interest: Dr. de Man has nothing to disclose.Conflict of interest: Dr. Marcus has nothing to disclose.Conflict of interest: Dr. Vonk Noordegraaf reports grants from Actelion, grants from GSK, grants from Pfizer, grants from Bayer, outside the submitted work.Conflict of interest: Dr. Symersky has nothing to disclose.Conflict of interest: Dr. Bogaard reports grants from Actelion, grants from GSK, grants from Pfizer, grants from Bayer, grants from Therabel, outside the submitted work. ER -