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Prevalence of pulmonary hypertension in myelofibrosis.
Annals of Hematology ( IF 3.5 ) Pub Date : 2020-02-19 , DOI: 10.1007/s00277-020-03962-2 Juan Lopez-Mattei 1 , Srdan Verstovsek 2 , Bryan Fellman 3 , Cezar Iliescu 1 , Karan Bhatti 4 , Saamir A Hassan 1 , Peter Kim 1 , Brian A Gray 5 , Nicolas L Palaskas 1 , Horiana B Grosu 6 , Mamas A Mamas 7 , Saadia A Faiz 6
Annals of Hematology ( IF 3.5 ) Pub Date : 2020-02-19 , DOI: 10.1007/s00277-020-03962-2 Juan Lopez-Mattei 1 , Srdan Verstovsek 2 , Bryan Fellman 3 , Cezar Iliescu 1 , Karan Bhatti 4 , Saamir A Hassan 1 , Peter Kim 1 , Brian A Gray 5 , Nicolas L Palaskas 1 , Horiana B Grosu 6 , Mamas A Mamas 7 , Saadia A Faiz 6
Affiliation
Pulmonary hypertension (PH) has been described in myelofibrosis (MF), but it is rare and typically found in advanced disease. Although the etiology of PH in MF is unclear, early predictors may be detected by echocardiogram. The goals of our study were to evaluate the prevalence of PH as determined by echocardiography in a cohort of MF patients and to identify clinical risk factors for PH. We performed a retrospective review of MF patients from October 2015 to May 2017 at MD Anderson Cancer Center in the ambulatory clinic, and those with echocardiogram were included. Clinical, echocardiographic, and laboratory data were reviewed. Patients with and without PH were compared using a chi-square or Fisher's exact test, and logistic regression was performed with an outcome variable of PH. There were 143 patients with MF who underwent echocardiogram, and 20 (14%) had echocardiographic findings consistent with PH. Older age, male gender, hypertension, hyperlipidemia, coronary artery disease, dyspnea, hematocrit, brain natriuretic peptide (BNP), and N-terminal prohormone BNP (NT-proBNP) were significantly different between those without PH and those with PH (p < 0.05). Female gender was protective (OR 0.21, 95% CI 0.049-0.90, p = 0.035), and NT-proBNP was a significant clinical predictor of PH (OR 1.07, CI 1.02 = 1.12, p = 0.006). PH in MF is lower than previously reported in our MF cohort, but many patients had cardiac comorbidities. PH due to left-sided heart disease may be underestimated in MF. Evaluation of respiratory symptoms and elevated NT-proBNP should prompt a baseline echocardiogram. Early detection of PH with a multidisciplinary approach may allow treatment of reversible etiologies.
中文翻译:
骨髓纤维化中肺动脉高压的患病率。
肺动脉高压 (PH) 已在骨髓纤维化 (MF) 中被描述,但它很少见,通常在晚期疾病中发现。虽然 MF 中 PH 的病因尚不清楚,但超声心动图可检测到早期预测因素。我们研究的目的是评估一组 MF 患者中通过超声心动图确定的 PH 患病率,并确定 PH 的临床危险因素。我们对 2015 年 10 月至 2017 年 5 月在 MD 安德森癌症中心门诊门诊的 MF 患者进行了回顾性研究,纳入了那些有超声心动图的患者。审查了临床、超声心动图和实验室数据。使用卡方或Fisher精确检验比较患有和不患有PH的患者,并使用PH的结果变量进行逻辑回归。143 例 MF 患者接受了超声心动图检查,和 20 (14%) 的超声心动图检查结果与 PH 一致。年龄较大、男性、高血压、高脂血症、冠状动脉疾病、呼吸困难、血细胞比容、脑利钠肽(BNP)和 N 端激素原 BNP(NT-proBNP)在无 PH 和有 PH 的患者之间存在显着差异(p < 0.05)。女性具有保护性(OR 0.21,95% CI 0.049-0.90,p = 0.035),NT-proBNP 是 PH 的重要临床预测因子(OR 1.07,CI 1.02 = 1.12,p = 0.006)。MF 中的 PH 低于我们之前在我们的 MF 队列中报告的,但许多患者有心脏合并症。在 MF 中可能会低估由左侧心脏病引起的 PH。呼吸道症状和 NT-proBNP 升高的评估应提示基线超声心动图。
更新日期:2020-02-19
中文翻译:
骨髓纤维化中肺动脉高压的患病率。
肺动脉高压 (PH) 已在骨髓纤维化 (MF) 中被描述,但它很少见,通常在晚期疾病中发现。虽然 MF 中 PH 的病因尚不清楚,但超声心动图可检测到早期预测因素。我们研究的目的是评估一组 MF 患者中通过超声心动图确定的 PH 患病率,并确定 PH 的临床危险因素。我们对 2015 年 10 月至 2017 年 5 月在 MD 安德森癌症中心门诊门诊的 MF 患者进行了回顾性研究,纳入了那些有超声心动图的患者。审查了临床、超声心动图和实验室数据。使用卡方或Fisher精确检验比较患有和不患有PH的患者,并使用PH的结果变量进行逻辑回归。143 例 MF 患者接受了超声心动图检查,和 20 (14%) 的超声心动图检查结果与 PH 一致。年龄较大、男性、高血压、高脂血症、冠状动脉疾病、呼吸困难、血细胞比容、脑利钠肽(BNP)和 N 端激素原 BNP(NT-proBNP)在无 PH 和有 PH 的患者之间存在显着差异(p < 0.05)。女性具有保护性(OR 0.21,95% CI 0.049-0.90,p = 0.035),NT-proBNP 是 PH 的重要临床预测因子(OR 1.07,CI 1.02 = 1.12,p = 0.006)。MF 中的 PH 低于我们之前在我们的 MF 队列中报告的,但许多患者有心脏合并症。在 MF 中可能会低估由左侧心脏病引起的 PH。呼吸道症状和 NT-proBNP 升高的评估应提示基线超声心动图。