Efthimiadis Georgios K, Parharidis Georgios E, Dourvas Ioannis N, Karvounis Haralambos I, Gemitzis Konstantinos D, Savvopoulos Gregorios K, Styliadis Ioannis H, Karoulas Takis N, Louridas Georgios E
1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
J Heart Valve Dis. 2004 Jan;13(1):46-52.
The effect of left ventricular (LV) pressure overload on right ventricular (RV) diastolic function has been extensively studied. In contrast, no data are available concerning the influence of LV volume overload on RV diastolic function. Accordingly, RV diastolic function was studied in patients with mitral regurgitation (MR) using Doppler echocardiography.
RV diastolic indices were calculated, using pulsed Doppler echocardiography, in 30 patients (mean age 56.87 +/- 8.58 years) with severe MR, and in 30 healthy control subjects (mean age 56.67 +/- 8.52 years).
Compared with controls, MR patients had a significantly lower RV E/A ratio (0.85 +/- 0.12 versus 1.21 +/- 0.16, p <0.001), a significantly prolonged RV isovolumic relaxation time (70 +/- 20 versus 30 +/- 10 ms, p <0.001), a significantly prolonged deceleration time of the transtricuspid E wave (210 +/- 20 versus 140 +/- 10 ms, p <0.001), and a significantly greater right atrial filling fraction (38.58 +/- 4.59 versus 32.58 +/- 3.14%, p <0.001). There was no statistically significant correlation between RV diastolic indices and LV mass index and interventricular septum thickness.
RV diastolic function in patients with MR is impaired, reflecting prolonged relaxation and redistribution of RV filling into late diastole. Ventricular interdependence constitutes the most likely mechanism of this action.
左心室（LV）压力超负荷对右心室（RV）舒张功能的影响已得到广泛研究。相比之下，关于LV容量超负荷对RV舒张功能的影响尚无数据可用。因此，本研究采用多普勒超声心动图对二尖瓣反流（MR）患者的RV舒张功能进行了研究。
使用脉冲多普勒超声心动图计算了30例重度MR患者（平均年龄56.87±8.58岁）和30例健康对照者（平均年龄56.67±8.52岁）的RV舒张指标。
与对照组相比，MR患者的RV E/A比值显著降低（0.85±0.12对1.21±0.16，p<0.001），RV等容舒张时间显著延长（70±20对30±10毫秒，p<0.001），三尖瓣E波减速时间显著延长（210±20对140±10毫秒，p<0.001），右心房充盈分数显著增加（38.58±4.59对32.58±3.14%，p<0.001）。RV舒张指标与LV质量指数和室间隔厚度之间无统计学显著相关性。
MR患者的RV舒张功能受损，反映出舒张期延长以及RV充盈重新分布至舒张晚期。心室相互依存是这种作用最可能的机制。
