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右心室组织多普勒成像的效用:与右心导管检查的相关性

Utility of right ventricular tissue Doppler imaging: correlation with right heart catheterization.

作者信息

Rajagopalan Navin, Simon Marc A, Shah Hemal, Mathier Michael A, López-Candales Angel

机构信息

Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15513-2582, USA.

出版信息

Echocardiography. 2008 Aug;25(7):706-11. doi: 10.1111/j.1540-8175.2008.00689.x. Epub 2008 Apr 27.

Abstract

OBJECTIVES

The objective of this study was to correlate tissue Doppler imaging of the right ventricle (RV) with pulmonary hemodynamics in patients referred for right heart catheterization.

METHODS

Seventy subjects (mean age 54 +/- 13; 35 males) prospectively underwent tissue Doppler imaging of the RV and right heart catheterization within 1 day of each other. Peak systolic velocity and strain were measured at the RV free wall and correlated with pulmonary hemodynamics.

RESULTS

RV myocardial velocity demonstrated no correlation with any hemodynamic variable. While RV strain demonstrated significant correlation with cardiac index (r =-0.61; P < 0.001), correlations with transpulmonary gradient (r = 0.26; P < 0.05) and pulmonary vascular resistance (r = 0.30; P < 0.05) were weaker. Subgroup analysis revealed that in patients with left ventricular systolic dysfunction (n = 31), RV strain showed no correlation with any hemodynamic variable. In patients with normal left ventricular systolic function (n = 39), correlations were significant between RV strain and mean pulmonary artery pressure (r = 0.59; P < 0.001), pulmonary vascular resistance (r = 0.60; P < 0.001), and cardiac index (r =-0.67; P < 0.001).

CONCLUSIONS

RV myocardial strain correlates significantly with pulmonary hemodynamics in patients with pulmonary hypertension and normal left ventricular function. However, there is no correlation with RV performance in patients with left ventricular dysfunction.

摘要

目的

本研究的目的是将接受右心导管检查患者的右心室组织多普勒成像与肺血流动力学进行关联分析。

方法

70名受试者(平均年龄54±13岁;35名男性)在彼此间隔1天的时间内前瞻性地接受了右心室组织多普勒成像和右心导管检查。测量右心室游离壁的收缩期峰值速度和应变,并与肺血流动力学进行关联分析。

结果

右心室心肌速度与任何血流动力学变量均无相关性。而右心室应变与心脏指数呈显著相关性(r = -0.61;P < 0.001),与跨肺压差(r = 0.26;P < 0.05)和肺血管阻力(r = 0.30;P < 0.05)的相关性较弱。亚组分析显示,在左心室收缩功能不全患者(n = 31)中,右心室应变与任何血流动力学变量均无相关性。在左心室收缩功能正常患者(n = 39)中,右心室应变与平均肺动脉压(r = 0.59;P < 0.001)、肺血管阻力(r = 0.60;P < 0.001)和心脏指数(r = -0.67;P < 0.001)之间存在显著相关性。

结论

在肺动脉高压且左心室功能正常的患者中,右心室心肌应变与肺血流动力学显著相关。然而,在左心室功能不全患者中,右心室应变与右心室功能无相关性。

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