Objective To construct a prediction model for pulmonary hypertension(PH)combining hemoglobin and cardiac ultrasound in patients with hypertrophic cardiomyopathy(HCM)by nomogram.Methods A retrospective analysis was performed for 151 patients diagnosed with HCM by echocardiography in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to March 2023,and the patients were divided into the experimental group(patients with PH,n=25)and control group(patients without PH,n=126)according to whether the patients developed PH.The general data,underlying disease history,serological examination indexes,and echocardiographic parameters of the two groups were collected and analyzed.Univariate and multivariate binary logistic regression analysis were used to obtain the independent risk factors for PH,and a prediction model was constructed;the R software(R4.3.2)was used to construct a nomogram to visualize the model and the receiver characteristic working curve(ROC curve)was drawn to verify the model and evaluate its predictive value for PH developing.Results The results of multivariate logistic regression analysis showed that the lower the hemoglobin in HCM patients(OR=0.968,95%CI 0.941～0.995),the larger the right atrial inner diameter(OR=1.132,95%CI 1.010～1.267),the larger the inner diameter of the pulmonary artery(OR=1.166,95%CI 1.012～1.345),the larger the ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral annulus(MV-E/e')(OR=1.196,95%CI 1.051～1.361)(all P<0.05),the higher the risk of developing PH.The prediction model was constructed using the above indicators;the nomogram was used to visualize the model;and the internal verification method of Bootstrap repeated sampling for 1000 times found that the predicted value was basically consistent with the measured value,indicating that the prediction model established was in good consistency;the C-index was calculated to be 0.843(95%CI 0.744～0.942),which had a good degree of discrimination.The area under the ROC curve of the prediction model is 0.843,which has high prediction efficiency.Conclusion The lower the hemoglobin,the larger the right atrial inner diameter,the larger the pulmonary artery diameter,and the larger the MV-E/e',the patients had more significantly increased risk of PH;and the nomogram model is helpful to evaluate the risk of PH in HCM patients,which has certain predictive efficacy.
维普
万方数据