TY - T1的持续运动不耐受后肺部动脉内膜切除术对慢性血栓栓塞肺动脉高压JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00109 -2020欧元六世- 55 - 6 SP - 2000109 AU Ruigrok Dieuwertje AU - Meijboom,莉莲J . AU - Nossent以斯帖J . AU - Boonstra Anco AU - Braams,Natalia J. AU - van Wezenbeek, Jessie AU - de Man, Frances S. AU - Marcus, J. Tim AU - Vonk Noordegraaf, Anton AU - Symersky, Petr AU - Bogaard，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，血流动力学的正常化是否意味着运动能力的正常化尚不清楚。PEA后运动不耐受的发生率、决定因素和临床意义尚不清楚。我们进行了一项前瞻性分析，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。方法所有患者在PEA前和术后6个月均按临床规程进行心肺运动试验(CPET)、右心导管和心脏磁共振(CMR)检查。运动不耐受的定义是预测峰值耗氧量(V 'O2)为80%。通过判断CPET参数来确定运动受限的原因。分析运动不耐受与静息血流动力学和cmr衍生的右心室功能之间的关系。采用logistic回归分析术前运动不耐受的潜在预测因素。结果68例患者纳入最终分析。 45 (66%) patients had exercise intolerance 6 months after PEA; in 20 patients this was primarily caused by a cardiovascular limitation. The incidence of residual pulmonary hypertension 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 pulmonary hypertension. In the multivariate analysis, preoperative transfer factor of the lung for carbon monoxide (TLCO) was the only predictor of exercise intolerance after PEA.Conclusions The majority of CTEPH patients have exercise intolerance after PEA, often despite normalisation of resting haemodynamics. Not all exercise intolerance after PEA is explained by the presence of residual pulmonary hypertension, and lower preoperative TLCO was a strong predictor of exercise intolerance 6 months after PEA.Despite normalisation of haemodynamics, exercise capacity remains abnormal in two-thirds of chronic thromboembolic pulmonary hypertension patients after pulmonary endarterectomy. Not all exercise intolerance is explained by the presence of residual PH. http://bit.ly/2Wie64s ER -