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Pulmonary Arterial Enlargement is Associated With Acute Chest Pain in Patients Without Obstructive Coronary Artery Disease

机译:无阻塞性冠状动脉疾病的患者肺动脉肿大与急性胸痛有关

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Background: Pulmonary hypertension (PH) is an underdiagnosed cause for chest pain in patients without significant coronary artery disease (CAD). Studies showed that enlarged pulmonary arterial (PA) and right ventricular chamber sizes correlate with the severity of PH. Therefore, we studied the association between chest pain, right ventricular dimensions (RVDs), and PA size on coronary coronary tomographic angiography (CCTA). Methods: The CCTA of 87 patients presenting with chest pain without evidence of obstructive CAD was examined. The PA diameter (PAD), right atrial dimension (RAD), and RVD were measured. A comparative control cohort included 31 patients who presented without cardiopulmonary complaints and underwent thoracic CT. The risk for obstructive sleep apnea (OSA) was assessed using STOP-BANG questionnaires. Results: Patients with chest pain without obstructive CAD showed markedly dilated right atrial and ventricular chambers compared with standard parameters (right atrium: 48?±?6.4?mm; right ventricle long axis: 61?±?9.5?mm). When comparing chest pain vs non-chest pain group, respectively, the mean PAD measured 25.92?±?0.43?mm vs 22.89?±?0.38?mm ( P ?
机译:背景:肺动脉高压(PH)是在没有明显冠状动脉疾病(CAD)的患者中未被诊断为胸痛的原因。研究表明,肺动脉(PA)增大和右心室大小与PH的严重程度相关。因此,我们研究了冠心病冠状动脉造影(CCTA)上的胸痛,右心室尺寸(RVD)和PA大小之间的关联。方法:对87例胸痛无阻塞性CAD的患者进行CCTA检查。测量PA直径(PAD),右心房尺寸(RAD)和RVD。对照人群包括31例无心肺不适且接受了胸部CT检查的患者。使用STOP-BANG问卷评估阻塞性睡眠呼吸暂停(OSA)的风险。结果:与标准参数相比,没有阻塞性CAD的胸痛患者显示右心房和心室明显扩张(右心房:48?±?6.4?mm;右心室长轴:61?±?9.5?mm)。当比较胸痛和非胸痛组时,PAD的平均值为25.92±±0.43?mm vs 22.89±±0.38?mm(P 。001),RAD2为40.1423±±0.7108?mm VS 34.8800±±1.0245mm(P≤0.0048),而RVD2测得31.7729±0.7299mm与27.6379±1.6178mm(P = 0.034)。在调整了年龄,性别,体重指数,高血压病史,高脂血症,充血性心力衰竭,慢性阻塞性肺疾病,OSA后,胸痛与较高的PAD相关(优势比[OR]:11.11,P 。05)。和吸烟。胸痛组的所有患者的STOP-BANG平均得分为3.9?±?1.8,无OSA病史的患者的平均STOP-BANG评分为3.62?±?0.20,代表该疾病的风险指数升高。结论:在没有CCTA阻塞性CAD表现的胸痛患者中,胸痛的存在与PAD增大之间有很强的联系。他们也是OSA的高风险人群。

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