Grapsa Ioulia, Pavlopoulos Harry, Dawson David, Gibbs J Simon R, Nihoyannopoulos Petros
Department of Cardiology and Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College School of Medicine, National Heart & Lung Institute, London, UK.
Hellenic J Cardiol. 2007 May-Jun;48(3):152-60.
Right ventricular function is a determinant of prognosis and survival in patients with pulmonary hypertension. The pulmonary hypertensive right ventricle has a complex shape. Transthoracic two-dimensional echocardiography is the primary examination for demonstrating right ventricular impairment. Nowadays, many indices have been linked with pulmonary hypertension. The myocardial performance index (MPI), which may be determined by both conventional Doppler and tissue Doppler imaging (TDI), is one of these.
Ninety-three patients with pulmonary hypertension were examined retrospectively over 3 years' treatment. The relationship between MPI and right ventricular impairment was studied, as well as the correlation with various echocardiographic determinants. In addition, we examined the correlation between conventional echocardiography and tissue Doppler imaging with reference to the MPI.
MPI had a statistically significant relationship with the visual estimation of right ventricular impairment (r = 0.714, p = 0.001), the degree of pulmonary regurgitation (r = 0.155, p = 0.048), left ventricular eccentricity index (r = 0.299, p = 0.001 in systole) and the presence of pericardial effusion (r = 0.199, p = 0.008), while it was inversely correlated with left ventricular fractional shortening (r = -0.284, p = 0.001). However, the index had no correlation with tricuspid regurgitant velocity, right ventricular acceleration time or right atrial volume. There was significant agreement between the MPI measured by conventional Doppler echocardiography and by TDI (r = 0.83, p < 0.001; mean value -0.10, SD 0.2). Finally, some patients showed a significant decrease in tricuspid regurgitant velocity and MPI during their treatment.
Right ventricular MPI has a good correlation with several parameters and can be a good prognostic factor for right ventricular impairment in patients with pulmonary hypertension.
右心室功能是肺动脉高压患者预后和生存的决定因素。肺动脉高压导致的右心室形态复杂。经胸二维超声心动图是显示右心室功能损害的主要检查方法。目前，许多指标都与肺动脉高压相关。心肌做功指数（MPI）可通过传统多普勒和组织多普勒成像（TDI）测定，是其中之一。
回顾性分析93例肺动脉高压患者3年的治疗情况。研究MPI与右心室功能损害的关系，以及与各种超声心动图指标的相关性。此外，参照MPI，我们还研究了传统超声心动图与组织多普勒成像之间的相关性。
MPI与右心室功能损害的视觉评估（r = 0.714，p = 0.001）、肺动脉反流程度（r = 0.155，p = 0.048）、左心室偏心指数（收缩期r = 0.299，p = 0.001）和心包积液的存在（r = 0.199，p = 0.008）具有统计学意义的相关性，而与左心室缩短分数呈负相关（r = -0.284，p = 0.001）。然而，该指数与三尖瓣反流速度、右心室加速时间或右心房容积无关。传统多普勒超声心动图和TDI测量的MPI之间具有显著一致性（r = 0.83，p < 0.001；平均值-0.10，标准差0.2）。最后，一些患者在治疗期间三尖瓣反流速度和MPI显著降低。
右心室MPI与多个参数具有良好的相关性，可作为肺动脉高压患者右心室功能损害的良好预后指标。
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