Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands.
J Cardiovasc Magn Reson. 2010 Jun 4;12(1):35. doi: 10.1186/1532-429X-12-35.
Longitudinal wall motion of the right ventricle (RV), generally quantified as tricuspid annular systolic excursion (TAPSE), has been well studied in pulmonary hypertension (PH). In contrast, transverse wall motion has been examined less. Therefore, the aim of this study was to evaluate regional RV transverse wall motion in PH, and its relation to global RV pump function, quantified as RV ejection fraction (RVEF).
In 101 PH patients and 29 control subjects cardiovascular magnetic resonance was performed. From four-chamber cine imaging, RV transverse motion was quantified as the change of the septum-free-wall (SF) distance between end-diastole and end-systole at seven levels along an apex-to-base axis. For each level, regional absolute and fractional transverse distance change (SFD and fractional-SFD) were computed and related to RVEF. Longitudinal measures, including TAPSE and fractional tricuspid-annulus-apex distance change (fractional-TAAD) were evaluated for comparison.
Transverse wall motion was significantly reduced at all levels compared to control subjects (p < 0.001). For all levels, fractional-SFD and SFD were related to RVEF, with the strongest relation at mid RV (R(2) = 0.70, p < 0.001 and R(2) = 0.62, p < 0.001). For TAPSE and fractional-TAAD, weaker relations with RVEF were found (R(2) = 0.21, p < 0.001 and R(2) = 0.27, p < 0.001).
Regional transverse wall movements provide important information of RV function in PH. Compared to longitudinal motion, transverse motion at mid RV reveals a significantly stronger relationship with RVEF and thereby might be a better predictor for RV function.
右心室（RV）的纵向壁运动，通常以三尖瓣环收缩期位移（TAPSE）来量化，在肺动脉高压（PH）中已经得到了很好的研究。相比之下，横向壁运动的研究较少。因此，本研究的目的是评估 PH 中 RV 横向壁的局部运动，并评估其与 RV 射血分数（RVEF）作为整体 RV 泵功能的关系。
在 101 例 PH 患者和 29 例对照者中进行心血管磁共振检查。从四腔心电影成像中，在沿着心尖至基底轴的七个水平上，通过测量舒张末期和收缩末期的间隔-游离壁（SF）距离来量化 RV 横向运动。对于每个水平，计算局部绝对和分数横向距离变化（SFD 和分数-SFD），并与 RVEF 相关。评估了纵向指标，包括 TAPSE 和分数三尖瓣环-心尖距离变化（fractional-TAAD）进行比较。
与对照组相比，所有水平的横向壁运动均显著降低（p < 0.001）。对于所有水平，分数-SFD 和 SFD 与 RVEF 相关，在中 RV 处相关性最强（R(2) = 0.70，p < 0.001 和 R(2) = 0.62，p < 0.001）。对于 TAPSE 和分数-TAAD，与 RVEF 的相关性较弱（R(2) = 0.21，p < 0.001 和 R(2) = 0.27，p < 0.001）。
局部横向壁运动提供了 PH 中 RV 功能的重要信息。与纵向运动相比，中 RV 的横向运动与 RVEF 具有更强的相关性，因此可能是 RV 功能的更好预测指标。
