フルイチ　ヨシヒロ   Furuichi Yoshihiro   古市　好宏    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Risk factors for portopulmonary hypertension in patients with cirrhosis: a prospective, multicenter study.
掲載誌名	正式名：Hepatology international 略　 称：Hepatol Int ISSNコード：19360541/19360533
掲載区分	国外
巻・号・頁	17(1),pp.139-149
著者・共著者	Atsukawa Masanori, Tsubota Akihito, Kondo Chisa, Koyano Kaori-Shioda, Ishikawa Toru, Toyoda Hidenori, Takaguchi Koichi, Watanabe Tsunamasa, Matsuura Kentaro, Ogawa Chikara, Hiraoka Atsushi, Okubo Hironao, Tateyama Masakuni, Uojima Haruki, Nozaki Akito, Chuma Makoto, Kato Keizo, Mikami Shigeru, Tani Joji, Morishita Asahiro, Kawata Kazuhito, Tada Toshifumi, Furuichi Yoshihiro, Okubo Tomomi, Kawano Tadamichi, Arai Taeang, Kawabe Naoto, Kawamura Naohiro, Ikegami Tadashi, Nakamuta Makoto, Shigefuku Ryuta, Iwasa Motoh, Tanaka Yasuhito, Hatano Masaru, Iwakiri Katsuhiko
発行年月	2023/02
概要	BACKGROUND:Tricuspid regurgitation pressure gradient (TRPG) measurement by echocardiography is recommended as the most objective examination to detect portopulmonary hypertension (PoPH). This study aimed to identify factors associated with a high TRPG in patients with cirrhosis and develop a scoring model for identifying patients who are most likely to benefit from echocardiography investigations.RESULTS:A total of 486 patients who underwent echocardiography were randomly allocated to the derivation and validation sets at a ratio of 2:1. Of the patients, 51 (10.5%) had TRPG ≥ 35 mmHg. The median brain natriuretic peptide (BNP) was 39.5 pg/mL. Shortness of breath (SOB) was reported by 91 (18.7%) patients. In the derivation set, multivariate analysis identified female gender, shortness of breath, and BNP ≥ 48.9 pg/mL as independent factors for TRPG ≥ 35 mmHg. The risk score for predicting TRPG ≥ 35 mmHg was calculated as follows: - 3.596 + 1.250 × gender (female: 1, male: 0) + 1.093 × SOB (presence: 1, absence: 0) + 0.953 × BNP (≥ 48.9 pg/mL: 1, < 48.9 pg/mL: 0). The risk score yielded sensitivity of 66.7%, specificity of 75.3%, positive predictive value of 25.5%, negative predict value of 94.3%, and predictive accuracy of 74.4% for predicting TRPG ≥ 35 mmHg. These results were almost similar in the validation set, indicating the reproducibility and validity of the risk score.CONCLUSIONS:This study clarified the characteristics of patients with suspected PoPH and developed a scoring model for identifying patients at high risk of PoPH, which may be used in selecting patients that may benefit from echocardiography.
DOI	10.1007/s12072-022-10456-y
PMID	36477691