Pulmonary to Systemic Flow Ratio in Precapillary Pulmonary Hypertension Without Left-to-Right Shunts: A Prognostic Implication of the Fick Method

Objective & Hypothesis:Objective: We routinely calculate the pulmonary to systemic (Qp/Qs) ratio to avoid missing any left-to-right shunts in patients with precapillary pulmonary hypertension (PH).

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Key Findings & Data:However, the pulmonary artery oxygen saturation (SpaO2) was lower than the mixed venous oxygen saturation (SmvO2) calculated using the formula; hence, the Qp/Qs ratio was calculated as less than “1” in some patients despite the absence of any detectable shunt.

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Conclusion & Impact:Nonsurvivors had lower Qp/Qs ratio than survivors (0.76±0.19 vs. 1.02±0.07 p

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Objective: We routinely calculate the pulmonary to systemic (Qp/Qs) ratio to avoid missing any left-to-right shunts in patients with precapillary pulmonary hypertension (PH). However, the pulmonary artery oxygen saturation (SpaO2) was lower than the mixed venous oxygen saturation (SmvO2) calculated using the formula; hence, the Qp/Qs ratio was calculated as less than “1” in some patients despite the absence of any detectable shunt. We hypothesized that this observation might have prognostic significance; however, to the best of our knowledge, it has not been investigated yet. Therefore, we aimed to examine the prognostic value of the Qp/Qs ratio in precapillary PH without left-to-right shunts. Methods: In this retrospective cohort study of 173 consecutive patients, hospital files were scanned for clinical, echocardiographic, and hemodynamic data including the Qp/Qs ratio calculated using the Fick method. Results: During a median follow-up of 25 months, 74 patients died. Nonsurvivors had lower Qp/Qs ratio than survivors (0.76±0.19 vs. 1.02±0.07 p

Özet

Amaç: Prekapiller pulmoner hipertansiyonlu (PH) hastalarda soldan sağa şantları kaçırmamak için pulmoner/sistemik oranı (Qp/Qs) rutin olarak hesaplamaktayız. Şaşırtıcı bir şekilde pulmoner arter oksijen satürasyonunun (SpaO2) formülle hesaplanan mikst venöz oksijen satürasyonundan (SmvO2) daha düşük olduğunu gözlemledik. Bu nedenle, saptanabilir herhangi bir şant olmamasına rağmen bazı hastalarda Qp/Qs değeri “1”den küçük olarak hesaplandı. Bu gözlemin prognostik öneme sahip olabileceğini varsaydık ve bildiğimiz kadarıyla bu henüz çalışılmadı. Bu nedenle soldan sağa şantı olmayan prekapiller PH’de Qp/Qs’in prognostik değerini araştırmayı amaçladık. Gereç ve Yöntem: Ardışık 173 hastayı içeren bu retrospektif kohort çalışmada, hastane dosyaları, Fick yöntemiyle hesaplanan Qp/Qs’i de içeren klinik, ekokardiyografik ve hemodinamik veriler için tarandı. Bulgular: Ortanca 25 ay takipte 74 hasta öldü. Ölenler, hayatta kalanlardan daha düşük Qp/Qs’e sahiplerdi (0,76±0,19’a karşılık 1,02±0,07; p

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Cite This Article

SEVİNÇ, C., ÖZPELİT, E., ACAR, B., AKDENİZ, B., BİRLİK, M., ŞENTÜRK, B., KAHRAMAN, B. Ö., TERTEMİZ, K. C., SEZGİN, D., YILMAZ, M. B. (2022). Pulmonary to Systemic Flow Ratio in Precapillary Pulmonary Hypertension Without Left-to-Right Shunts: A Prognostic Implication of the Fick Method. Bakırköy Tıp Dergisi, Cilt: 17 - Sayı: 3, 227–232. https://ajindex.com/articles/459998

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