López-Candales A, Dohi K, Rajagopalan N, Edelman K, Gulyasy B, Bazaz R
University of Pittsburgh, Cardiovascular Institute, Scaife 560, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA.
Postgrad Med J. 2008 Jan;84(987):40-5. doi: 10.1136/pgmj.2007.059642.
Right ventricular (RV) fractional area change and tricuspid annular plane systolic excursion (TAPSE) are recognised methods for assessing RV function. However, the way in which these variables are affected by varying degrees of pulmonary hypertension (PH) has not been well characterised.
RV end-systolic area (RVESA), RV end-diastolic area (RVEDA), pulmonary artery systolic pressure (PASP) and TAPSE were collected from a database of 190 patients who had been referred to the PH clinic for evaluation.
The mean (SD) age of the study population was 56 (17) years; 82 men were included with a mean (SD) PASP of 54 (33) mm Hg (range 16-150), RVESA of 14 (9) cm(2), RVEDA of 24 (9) cm(2), RV fractional area change of 44 (18)% and TAPSE of 2.06 (0.69) cm. Receiver-operating characteristic curves identified TAPSE <2.01 cm, RV fractional area change <40.9%, RVESA >12.3 cm(2) and RVEDA >23.4 cm(2) as abnormal values with PH. Finally stratification of patients into sub-groups according to their PASP allowed means and standard deviations to be reported for each echocardiographic variable.
This analysis provides a range of normal variables of RV size and function, not previously published, that can be used in routine evaluation and follow-up of patients with PH.
右心室(RV)面积变化分数和三尖瓣环平面收缩期位移(TAPSE)是评估右心室功能的公认方法。然而,这些变量受不同程度肺动脉高压(PH)影响的方式尚未得到充分描述。
从190名转诊至PH门诊进行评估的患者数据库中收集右心室收缩末期面积(RVESA)、右心室舒张末期面积(RVEDA)、肺动脉收缩压(PASP)和TAPSE。
研究人群的平均(标准差)年龄为56(17)岁;纳入82名男性,平均(标准差)PASP为54(33)mmHg(范围16 - 150),RVESA为14(9)cm²,RVEDA为24(9)cm²,RV面积变化分数为44(18)%,TAPSE为2.06(0.69)cm。受试者工作特征曲线确定TAPSE <2.01 cm、RV面积变化分数<40.9%、RVESA >12.3 cm²和RVEDA >23.4 cm²为PH患者的异常值。最后根据患者的PASP将其分层为亚组,报告每个超声心动图变量的均值和标准差。
本分析提供了一系列此前未发表的右心室大小和功能的正常变量,可用于PH患者的常规评估和随访。