Pettersen Eirik, Helle-Valle Thomas, Edvardsen Thor, Lindberg Harald, Smith Hans-Jørgen, Smevik Bjarne, Smiseth Otto A, Andersen Kai
Department of Cardiology, Faculty of Medicine, University of Oslo and Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
J Am Coll Cardiol. 2007 Jun 26;49(25):2450-6. doi: 10.1016/j.jacc.2007.02.062. Epub 2007 Jun 11.
The aim of the present study was to characterize the contraction pattern of the systemic right ventricle (RV).
Reduced longitudinal function of the systemic RV compared with the normal RV has been interpreted as ventricular dysfunction. However, longitudinal shortening represents only one aspect of myocardial deformation, and changes in contraction in other dimensions have not previously been described.
Fourteen Senning-operated patients age 18.4 +/- 0.9 years (mean +/- SD) with transposition of the great arteries were studied. We compared the contraction pattern of the systemic RV with findings in the RV and left ventricle (LV) of normal subjects (n = 14) using tissue Doppler imaging and magnetic resonance imaging.
In the systemic RV free wall, circumferential strain exceeded longitudinal strain (-23.3 +/- 3.4% vs. -15.0 +/- 3.0%, p < 0.001) as was also the case in the normal LV (-25.7 +/- 3.1% vs. -16.5 +/- 1.7%, p < 0.001), opposite from the findings in the normal RV (-15.8 +/- 1.3% vs. -30.7 +/- 3.3%, p < 0.001). Strain in the interventricular septum did not differ from normal. Ventricular torsion was essentially absent in the systemic RV (0.3 +/- 1.8 degrees ), in contrast to a torsion of 16.7 +/- 4.8 degrees in the normal LV (p < 0.001).
In the systemic RV as in the normal LV, there was predominant circumferential over longitudinal free wall shortening, opposite from findings in the normal RV. This may represent an adaptive response to the systemic load. Noticeably, however, the systemic RV did not display torsion as found in the normal LV.
本研究旨在描述系统性右心室（RV）的收缩模式。
与正常右心室相比，系统性右心室纵向功能降低被解释为心室功能障碍。然而，纵向缩短仅代表心肌变形的一个方面，其他维度收缩的变化此前尚未被描述。
对14例年龄为18.4±0.9岁（均值±标准差）、患有大动脉转位且接受森宁手术的患者进行研究。我们使用组织多普勒成像和磁共振成像，将系统性右心室的收缩模式与正常受试者（n = 14）的右心室和左心室（LV）的结果进行比较。
在系统性右心室游离壁，圆周应变超过纵向应变（-23.3±3.4%对-15.0±3.0%，p < 0.001），正常左心室也是如此（-25.7±3.1%对-16.5±1.7%，p < 0.001），这与正常右心室的结果相反（-15.8±1.3%对-30.7±3.3%，p < 0.001）。室间隔的应变与正常情况无差异。系统性右心室基本不存在心室扭转（0.3±1.8度），而正常左心室的扭转角度为16.7±4.8度（p < 0.001）。
与正常左心室一样，系统性右心室游离壁圆周缩短占主导，超过纵向缩短，这与正常右心室结果相反。这可能代表对体循环负荷的适应性反应。然而，值得注意的是，系统性右心室并未表现出正常左心室中存在的扭转。
