Gondi Sreedevi, Dokainish Hisham
Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas 77030, USA.
Echocardiography. 2007 May;24(5):522-32. doi: 10.1111/j.1540-8175.2007.00430.x.
Although tissue Doppler (TD) imaging of the left ventricle is now commonly used in clinical settings, TD imaging of the right ventricle (RV) is not routinely practiced. Yet, there are significant data on clinical uses of RV TD imaging, including established normal values using both color and spectral TD. In acute left ventricular (LV) inferior wall myocardial infarction, depressed RV TD velocities have been shown to correlate with the presence of RV impairment, and with patient outcome. In patients with LV heart failure, TD imaging has been correlated to RV ejection fraction by radionuclide angiography, and is an independent predictor of outcome. In patients with congenital heart disease, RV TD has been especially valuable for assessing RV function, and has been correlated to invasive hemodynamic indices, and RV ejection fraction by magnetic resonance imaging. The RV performance (Tei) index has been calculated and validated using TD-derived, rather than conventional pulsed Doppler time intervals. RV TD indices have been shown to be useful in the detection of subclinical and clinical disease in morbid obesity, chronic pulmonary, and systemic disease. TD-derived RV strain imaging can detect segmental myocardial dysfunction, overcoming limitations to conventional TD imaging resulting from tethering. For both TD velocity and strain imaging, however, appreciation of the limitations of these techniques is necessary for their appropriate use. Given its rapid acquisition times, reproducibility, and ease of addition to standard transthoracic echocardiographic protocols, RV TD and strain imaging are important additional modalities in the comprehensive echo-Doppler assessment of RV function.
尽管左心室组织多普勒（TD）成像目前在临床环境中已普遍使用，但右心室（RV）的TD成像并未常规开展。然而，关于RV TD成像临床应用的重要数据是存在的，包括使用彩色和频谱TD确定的正常数值。在急性左心室（LV）下壁心肌梗死中，已表明RV TD速度降低与RV功能受损的存在以及患者预后相关。在LV心力衰竭患者中，TD成像已通过放射性核素血管造影与RV射血分数相关联，并且是预后的独立预测指标。在先天性心脏病患者中，RV TD对于评估RV功能特别有价值，并且已与有创血流动力学指标以及磁共振成像测得的RV射血分数相关联。RV性能（Tei）指数已使用TD衍生而非传统脉冲多普勒时间间隔进行计算和验证。RV TD指数已被证明在检测病态肥胖、慢性肺部疾病和全身性疾病中的亚临床和临床疾病方面有用。TD衍生的RV应变成像可以检测节段性心肌功能障碍，克服了由于牵拉导致的传统TD成像的局限性。然而，对于TD速度和应变成像而言，了解这些技术的局限性对于其正确使用是必要的。鉴于其采集时间短、可重复性强且易于添加到标准经胸超声心动图检查方案中，RV TD和应变成像在RV功能的综合超声多普勒评估中是重要的补充方式。
