Niederle P, Jezek V, Jezková J, Michaljanic A
Ustav fyziologických regulací CSAV Praha.
Vnitr Lek. 1991 Apr;37(4):313-22.
Using two-dimensional echocardiography (ECHO), the authors examined within one week preceding right-sided catheterization of the right ventricle (RV) 44 patients. Of three tested ECHO techniques for calculation of right ventricular volumes and/or function the best correlations were obtained by the method of evaluation of area-length of the right ventricle from two orthogonal projections (apical 4-cavity and subcostal with visualization of the outflow portion of the RV). The following correlations were assessed: telediastolic volume--r = 0.831, telesystolic volume--r = 0.815 stroke volume--r = 0.810 and ejection fraction (EF)--r = 0.752 (p less than 0.001 for all correlations). The tested method enables us at the same time to screen at least existing right ventricular dysfunction (sensitivity 0.68; specificity 0.82). In the presence of tricuspidal insufficiency (TI) increase in right ventricular function occurs which may mask its existing failure (dependence of EF on the mean pressure level in pulmonary artery was proved only in patients without TI--r = 0.594). We assume that information on right ventricular function is important not only in diseases affecting primarily the right heart but also in advanced stages of left-sided failure. Follow-up of the natural course of the disease and the effect of provided treatment by the non-invasive ECHO method is thus useful not only in research but also in clinical practice.
作者使用二维超声心动图（ECHO）对44例患者在右心室（RV）进行右侧心导管检查前一周内进行了检查。在三种用于计算右心室容积和/或功能的ECHO技术中，通过从两个正交投影（心尖四腔心和肋下，显示RV流出部分）评估右心室面积-长度的方法获得了最佳相关性。评估了以下相关性：舒张末期容积——r = 0.831，收缩末期容积——r = 0.815，每搏输出量——r = 0.810，射血分数（EF）——r = 0.752（所有相关性的p均小于0.001）。所测试的方法使我们能够同时至少筛查出现有的右心室功能障碍（敏感性0.68；特异性0.82）。在存在三尖瓣关闭不全（TI）的情况下，右心室功能会增强，这可能掩盖其现有的衰竭（仅在无TI的患者中证明EF与肺动脉平均压力水平相关——r = 0.594）。我们认为，关于右心室功能的信息不仅在主要影响右心的疾病中很重要，而且在左侧心力衰竭的晚期也很重要。因此，通过无创ECHO方法对疾病的自然病程和所提供治疗的效果进行随访不仅在研究中有用，而且在临床实践中也有用。
