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应用应变率成像评估慢性阻塞性肺疾病患者的右心室功能

Assessment of right ventricular function by strain rate imaging in chronic obstructive pulmonary disease.

作者信息

Vitarelli A, Conde Y, Cimino E, Stellato S, D'Orazio S, D'Angeli I, Nguyen B L, Padella V, Caranci F, Petroianni A, D'Antoni L, Terzano C

机构信息

La Sapienza University, Rome, Italy.

出版信息

Eur Respir J. 2006 Feb;27(2):268-75. doi: 10.1183/09031936.06.00072005.

Abstract

The purpose of the current study was to compare right ventricular (RV) myocardial wall velocities (tissue Doppler imaging) and strain rate imaging (SRI) parameters with conventional echocardiographic indices evaluating RV function in chronic obstructive pulmonary disease (COPD) patients. In total, 39 patients with COPD and 22 healthy subjects were included in the current study. Seventeen patients had pulmonary artery pressure <35 mmHg (group I) and 22 patients had pulmonary artery pressure >35 mmHg (group II). Tissue Doppler imaging, strain and strain rate (SR) values were obtained from RV free wall (FW) and interventricular septum. Respiratory function tests were performed (forced expiratory volume in one second/vital capacity (FEV(1)/VC) and carbon monoxide diffusion lung capacity per unit of alveolar volume (D(L,CO)/V(A))). Strain/SR values were reduced in all segments of group II patients compared with group I patients and controls with lowest values at basal FW site. A significant relationship was shown between peak systolic SR at basal FW site and radionuclide RV ejection fraction. A significant relationship was shown between peak systolic SR at basal FW site and D(L,CO)/V(A) and FEV(1)/VC. In conclusion, in chronic obstructive pulmonary disease patients, strain rate imaging parameters can determine right ventricular dysfunction that is complementary to conventional echocardiographic indices and is correlated with pulmonary hypertension and respiratory function tests.

摘要

本研究的目的是比较慢性阻塞性肺疾病(COPD)患者右心室(RV)心肌壁速度(组织多普勒成像)和应变率成像(SRI)参数与评估右心室功能的传统超声心动图指标。本研究共纳入39例COPD患者和22例健康受试者。17例患者肺动脉压<35 mmHg(I组),22例患者肺动脉压>35 mmHg(II组)。从右心室游离壁(FW)和室间隔获取组织多普勒成像、应变和应变率(SR)值。进行呼吸功能测试(一秒用力呼气量/肺活量(FEV(1)/VC)和每单位肺泡容积一氧化碳弥散肺容量(D(L,CO)/V(A)))。与I组患者和对照组相比,II组患者所有节段的应变/SR值均降低,在FW基底部节段的值最低。FW基底部节段的收缩期峰值SR与放射性核素右心室射血分数之间存在显著相关性。FW基底部节段的收缩期峰值SR与D(L,CO)/V(A)和FEV(1)/VC之间存在显著相关性。总之,在慢性阻塞性肺疾病患者中,应变率成像参数可确定右心室功能障碍,这是对传统超声心动图指标的补充,且与肺动脉高压和呼吸功能测试相关。

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