Adhyapak Srilakshmi M, Pujar Suresh V, Mahala Bijay K, Shetty Pradeep K
Department of Cardiology, Narayana Hrudayalaya, Bangalore.
Indian Heart J. 2006 Jul-Aug;58(4):341-4.
The aim of this study was to investigate the reasons for better prognosis in adults with Eisenmenger's syndrome than those suffering from idiopathic pulmonary hypertension. Our hypothesis was that right ventricular function is better preserved in the former case than in the latter.
We used two-dimensional echocardiography and tissue Doppler imaging to compare right ventricular morphology and function in 24 subjects with Eisenmenger's syndrome and 23 age- and sex-matched subjects with idiopathic pulmonary hypertension.
The mean age was 27.4+/-12.2 years for both groups. There were more patients from the idiopathic pulmonary hypertension group in the New York Heart Association Class III than those from the Eisenmenger's syndrome group (48.4% vs 36.3%; p<0.01). Measurements of the right and left ventricular free wall thickness, as well as the internal diameter of the right ventricle were taken, and tissue Doppler imaging was used to assess the function of both ventricles. In the Eisenmenger's group, the mean right ventricular and left ventricular free wall thickness was 10.4+/-2.78 mm and 9.7+/-1.98 mm, respectively. The mean right ventricular internal diameter in diastole and in systole were 20+/-8.64 mm and 18.1+/-9.24 mm, respectively. The mean right ventricular S1 was 10.4+/-3.4 cm/sec and S2, 10.3+/-2.6 cm/sec, while the left ventricular S1 was 7.4+/-1.87 cm/s and S2, 7.5+/-1.05 cm/sec, with a normal biventricular function. In the idiopathic pulmonary hypertension group, the mean right ventricular and left ventricular free wall thickness was 11.3+/-3.24 mm and 9.8+/-1.94 mm, respectively. The mean right ventricular internal diameter in diastole and systole was 36+/-8.9 mm and 30.1+/-9.8 mm, respectively. The mean right ventricular S1 was 6.9+/-3.4 cm/sec and S2, 6.8+/-2.8 cm/sec, while the left ventricular S1 was 7.4+/-1.8 cm/sec and S2, 7.5+/-1.05 cm/sec, reflecting right ventricular systolic dysfunction.
Right ventricular function was better preserved among subjects with Eisenmenger's syndrome than those with idiopathic pulmonary hypertension in a study in which the two groups were matched for age and sex.
本研究旨在探究艾森曼格综合征成年患者预后优于特发性肺动脉高压患者的原因。我们的假设是，前者的右心室功能比后者保存得更好。
我们使用二维超声心动图和组织多普勒成像，比较24例艾森曼格综合征患者与23例年龄和性别匹配的特发性肺动脉高压患者的右心室形态和功能。
两组的平均年龄均为27.4±12.2岁。纽约心脏协会心功能Ⅲ级的特发性肺动脉高压组患者多于艾森曼格综合征组（48.4% 对36.3%；p<0.01）。测量了右心室和左心室游离壁厚度以及右心室内径，并使用组织多普勒成像评估两个心室的功能。在艾森曼格综合征组中，右心室和左心室游离壁的平均厚度分别为10.4±2.78mm和9.7±1.98mm。舒张期和收缩期右心室内径的平均值分别为20±8.64mm和18.1±9.24mm。右心室S1的平均值为10.4±3.4cm/秒，S2为10.3±2.6cm/秒，而左心室S1为7.4±1.87cm/秒，S2为7.5±1.05cm/秒，双心室功能正常。在特发性肺动脉高压组中，右心室和左心室游离壁的平均厚度分别为11.3±3.24mm和9.8±1.94mm。舒张期和收缩期右心室内径的平均值分别为36±8.9mm和30.1±9.8mm。右心室S1的平均值为6.9±3.4cm/秒，S2为6.8±2.8cm/秒，而左心室S1为7.4±1.8cm/秒，S2为7.5±1.05cm/秒，提示右心室收缩功能障碍。
在一项两组年龄和性别匹配的研究中，艾森曼格综合征患者的右心室功能比特发性肺动脉高压患者保存得更好。
