| Objective To analyze the hospitalization constituent ratio of Pulmonary Artery Hypertension(PAH) in Fuwai hospital,ascertain the etiology and constituent ratio of PAH in recent years.Methods Retrospectively analyze the cases who were diagnosed as PAH from Jan 2006 to Dec 2008 in Fuwai hospital,Statistical analysis software was SPSS 13.0. Results 6405 cases(9.21%) were diagnosed as PAH in Fuwai hospital from Jan 2006 to Dec 2008,including 14 diseases which belonged to the 5 types of PAH classified by venic conference in 2003:Congenital Heart Disease 4194 cases(65.5%),Left Heart Disease 1471 cases(23.0%),Idiopathic and Familial PAH 282 cases(4.4%),Chronic Pulmonary Thromboembolism 222 cases(3.5%),Collagen Vascular Disease 108 cases(1.7%),Pulmonary Vasculitis 35 cases(0.5%),Respiratory System Disease 30 cases(0.5%),Takayasu arteritis 25 cases(0.4%),Thyroid disease 11 cases,Portal Hypertension 9 cases,Hereditary Telangiectasia 9 cases,Drug 4 cases,Pulmonary Artery Maldevelopment 2 cases,Fibrosing Mediastinitis 1 case,Sarcoidosis 1 case.The proportion of PAH patients is 7.98%,9.55%and 9.92%in all patients in 2006,2007 and 2008 respectively,Idiopathic and Familial PAH amount to 549 cases,the proportion of which is 4.07%in PAH in the past 15 years.Conclusion The most common etiology of PAH are congenital heart disease and left heart disease,Chronic Pulmonary Thromboembolism and Respiratory System Disease related PAH decreased but Collagen Vascular Disease related PAH increased in the last three years,the proportion of IPAH in PAH is stable. Objective To analyze the characteristics of IPAH and predict the prognosis of IPAH by Echocardiogram and Right Heart Catheterization(RHC).Methods Retrospectively analyze the cases who were diagnosed as IPAH from Jan 2003 to Jun 2007 in Fuwai hospital,Statistical analysis software was SPSS13.0.Results The mean age of the 108 IPAH cases was(32.5±12.6) years,the ratio of female and male was 2.86:1,the average time from appearing symptom to diagnosis was (34.9±36.3) months,the incidence of syncope,hepatomegaly,hemoptysis and Edema of lower extremity was 32.4%,27.8%,15.7%and 14.8%,respectively.A total of 94 cases(87.0%) were followed up for(27.6±14.7) months,forty-two cases(38.9%)died of right heart failure,The survival rate of 1,2 and 3 years was 74%,58%and 44% respectively.The Pulmonary Arterial Systolic Pressure measured by Echocardiogram (Echo-PASP) has a linear positive correlation with the PASP measured by Right Heart Catheterization(RHC-PASP),the equation is RHC-PASP(mmHg)= Echo-PASP (mmHg)×0.525+ 47.55 mmHg.These following variables were valuable in univariate analysis:Pulse Pressure(PP)(P=0.000,RR=0.930),The ratio of right and left ventricular end-diastolic diameter(RVEDD/LVEDD)(P=0.003,RR=3.222),Echo-PASP(P=0.002, RR=1.022),RHC-PASP(P=0.030,RR=1.026),RHC-Mpap(P=0.031,RR=1.037), Pulmonary Vascular Resistance(PVR) measured by RHC(P=0.019,RR=1.001) and drug therapy.In multivariate analysis,PP(P=0.000,RR=0.923),Echo-PASP(P=0.002, RR=1.022),RVEDD/LVEDD(P=0.006,RR=3.126),RHC-PASP(P=0.016,RR=1.033), RHC-mPAP(P=0.038,RR=1.038) and PVR(P=0.017,RR=1.001) were predictive.Conclusion IPAH was prone to attack young women with a poor prognosis,the diagnosis of IPAH at an early stage was difficult because of nonspecific symptom.Syncope, hepatomegaly and Edema of lower extremity can predict the severity of IPAH, Echocardiogram is a excellent noninvasive method to measure PASP.PP,Echo-PASP, RVEDD/LVEDD,RHC-PASP,RHC-mPAP and PVR measured by RHC can predict the prognosis of IPAH. Objective To analyze the correlation between the biochemical indicator in plasma(big endotheline-1 and NT-proBNP) and physical examination(Echocardiogram and Right Heart Catheterization),evaluate the values of big endotheline-1(Big ET-1) and NT-proBNP in predicting the severity and prognosis of IPAH.Methods The plasma concentration of big endotheline-1 and NT-proBNP in the patients who were diagnosed as IPAH from Jan 2003 to Jun 2007 in Fuwai hospital were analyzed. Statistical analysis software was SPSS13.0.Result The plasma concentration of Big ET-1 was no difference between male and female(P = 0.173).In Pearson correlation analysis,the plasma concentration of Big ET-1 was positively related to the ratio of right and left ventricular end-diastolic diameter (R=0.354,P=0.013),NT-proBNP(R=0.471,P=0.000) mPAP(R=0.324,P=0.034) and PVR(R=0.405,P=0.009).the NT-proBNP was positively related to the ratio of right and left ventricular end-diastolic diameter(R=0.490,P=0.000) and PVR(R=0.334,P=0.014). the equation of linear correlation between big ET-1 and mPAP is mPAP=big ET-1×2.84+58.74.The arterial partial pressure of oxygen(P=0.011,RR=0.966) and plasma concentration of Big ET-1(P=0.012,RR=1.305) could predict survival in univariate analysis,in multivariate analysis,plasma concentration of Big ET-1(P=0.015, RR=1.315)was predictive.Conclusion NT-proBNP can evaluate the recent heart function,but can not predict the mortality in short and long terms.The plasma concentration of Big ET-1 was no difference between male and female,it was positively correlated with the ratio of right and left ventricular end-diastolic diameter,NT-proBNP,mPAP and PVR,Big ET-1 can predict the prognosis of IPAH. Objective to analyze the correlation between quantitative analysis of Lung perfusion scan and the severity of IPAH.Methods Lung perfusion scan and Right Heart Catheterization(RHC) were performed in 24 IPAH patients,we calculate the Ratio of Upper and Lower Lung field Radioactive Counts(URC/LRC) and analyze the correlation between URC/LRC and the data of RHC, Statistical analysis software was SPSS 13.0.Result The URC/LRC of left and right lung was 0.65±0.28 and 0.69±0.40 respectively in the 24 IPAH patients,mean Pulmonary Artery Pressure(mPAP) and Pulmonary Vascular(PVR) was(66.5±16.40)mmHg and(1627.4±654.5) dyn·s·cm-5/m2.Pearson correlation analysis demonstrate that the URC/LRC is correlated with mPAP and PVR in both lung.The scatter plot show that the URC/LRC has a linear correlation trend with mPAP and PVR,the linear regression equation is mPAP(mmHg)=URC/LRC×33.11 +45.13 and PVR=URC/LRC×1511.8+650.4 in the left lung,mPAP(mmHg)=URC/LRC×20.84+52.20 and PVR=URC/LRC×1199.8+802.9 in the right lung.Conclusion The URC/LRC has a linear positive correlation with mPAP and PVR,we can estimate the Pulmonary Artery Pressure(PAP) and evaluate the severity of IPAH by the URC/LRC.
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