Zagatina Angela, Zhuravskaya Nadezhda, Kotelnikova Anna, Tyurina Tatyana V
Leningrad Regional Cardiologic Dispensary, St Petersburg, Russia.
Coron Artery Dis. 2009 Dec;20(8):525-30. doi: 10.1097/MCA.0b013e328330d52c.
Assessing right ventricle (RV) function is difficult primarily because of its complex shape. Worsening RV function or dilatation during stress tests in patients with coronary artery disease may indicate proximal right coronary artery (RCA) narrowing. The aim of this study was to obtain quantitative diagnostic criteria for impaired RV function by tissue Doppler imaging (TDI) during exercise echocardiography, which could detect a significant lesion of the RCA in patients with coronary artery disease.
We evaluated regional systolic and diastolic function using pulsed-wave TDI in two myocardial segments of the RV free wall during exercise stress tests in 160 patients with suspected coronary artery disease. The diagnostic criteria were obtained by comparing TDI and coronary angiography data. The accuracy, sensitivity, and specificity of the TDI diagnostic model for RCA disease were 81.1, 88.0, and 72.3%, respectively.
TDI is a highly accurate method for the detection of RV dysfunction and RCA disease at rest and during exercise stress echocardiography in group of patients with known or suspected coronary artery disease.
评估右心室(RV)功能存在困难,主要原因在于其形状复杂。在冠心病患者的负荷试验中,右心室功能恶化或扩张可能提示右冠状动脉(RCA)近端狭窄。本研究的目的是通过运动超声心动图期间的组织多普勒成像(TDI)获得右心室功能受损的定量诊断标准,该标准能够检测出冠心病患者的右冠状动脉显著病变。
我们在160例疑似冠心病患者的运动负荷试验期间,使用脉冲波TDI评估右心室游离壁两个心肌节段的局部收缩和舒张功能。通过比较TDI和冠状动脉造影数据获得诊断标准。TDI诊断模型对右冠状动脉疾病的准确性、敏感性和特异性分别为81.1%、88.0%和72.3%。
在已知或疑似冠心病患者群体中,TDI是一种在静息及运动负荷超声心动图检查时检测右心室功能障碍和右冠状动脉疾病的高度准确的方法。