Patel Neil, Mills John F, Cheung Michael M H
Royal Hospital for Sick Children, Dalnair Street, Yorkhill, Glasgow, G3 8SJ, UK.
Pediatr Cardiol. 2009 Feb;30(2):133-7. doi: 10.1007/s00246-008-9285-1. Epub 2008 Aug 15.
This study aimed to measure and compare right ventricular (RV) function in normal infants and those with pulmonary hypertension (PHT) using the myocardial performance index (RVMPI) and to investigate the relationship between RV function and pulmonary artery pressure.
A case-control study measured RVMPI in 16 infants with PHT (9 of whom had congenital diaphragmatic hernia) and 28 normal control infants. For the PHT infants, 43 paired measures of RVMPI and pulmonary artery pressure (estimated from tricuspid regurgitation jet velocity) were taken to allow investigation of the relationship between RVMPI and pulmonary artery pressure.
The mean RVMPI for the control infants was 0.24+/-0.09. The RVMPI was significantly elevated in the PHT group (0.55+/-0.17; p<0.0001), including a subgroup of infants with PHT secondary to congenital diaphragmatic hernia (0.58+/-0.18; p<0.0001). The correlation between RVMPI and pulmonary artery pressure in the infants with PHT (R2=0.05; p=0.17) was poor.
In infants, RVMPI allows quantification of right ventricular function and detection of RV dysfunction in PHT. No linear relationship exists between RVMPI pulmonary artery pressure. Use of RVMPI in the clinical setting must take into account the global and load-dependent nature of this measure.
本研究旨在使用心肌性能指数（RVMPI）测量并比较正常婴儿和患有肺动脉高压（PHT）婴儿的右心室（RV）功能，并研究RV功能与肺动脉压力之间的关系。
一项病例对照研究测量了16例患有PHT的婴儿（其中9例患有先天性膈疝）和28例正常对照婴儿的RVMPI。对于患有PHT的婴儿，获取了43对RVMPI和肺动脉压力（根据三尖瓣反流射流速度估算）的测量值，以研究RVMPI与肺动脉压力之间的关系。
对照婴儿的平均RVMPI为0.24±0.09。PHT组的RVMPI显著升高（0.55±0.17；p<0.0001），包括继发于先天性膈疝的PHT婴儿亚组（0.58±0.18；p<0.0001）。患有PHT的婴儿中，RVMPI与肺动脉压力之间的相关性较差（R2=0.05；p=0.17）。
在婴儿中，RVMPI可用于量化右心室功能并检测PHT中的RV功能障碍。RVMPI与肺动脉压力之间不存在线性关系。在临床环境中使用RVMPI时，必须考虑该测量方法的整体性质和负荷依赖性。
