Kucukdurmaz Zekeriya, Karapinar Hekim, Karavelioğlu Yusuf, Açar Göksel, Gul Ibrahim, Emiroglu Mehmet Yunus, Bulut Mustafa, Esen Ali Metin
Department of Cardiology, Cumhuriyet University, Medical School, Sivas, Turkey.
Echocardiography. 2012 Apr;29(4):451-4. doi: 10.1111/j.1540-8175.2011.01614.x. Epub 2012 Feb 13.
We aimed to investigate the effect of controlled and limited volume change by the blood donation model to the right ventricular (RV) function via different echocardiographic parameters in healthy adults.
Study population was composed of 71 healthy subjects who were volunteers for blood donation and evaluated before and after 450 mL blood donation. Pulsed-wave Doppler of the RV inflow and tissue Doppler of tricuspid lateral annulus, and tricuspid annular plane systolic excursion (TAPSE) were assessed.
E velocity of inflow decreased significantly (67.6 ± 15.9 vs 60.9 ± 12.2, P = 0.006). S' and A' velocities did not change (15.3 ± 3.2 vs 15.2 ± 2.5 cm/s, P = NS; 14.1 ± 3.3 vs 13.4 ± 3.1 cm/s, P = NS, respectively) but E' showed significant decrease (13.7 ± 2.9 vs 12.2 ± 3.2 cm/s, P = 0.011). E'/A' ratio and E/E' ratio were found to be unchanged (1.0 ± 0.3 vs 1.0 ± 0.4, P = NS; 5.1 ± 2 vs 5.3 ± 2, P = NS, respectively). Myocardial performance index (MPI) was found to be increased but ejection time obtained from the tricuspid annulus did not change (0.50 ± 0.13 vs 0.54 ± 0.11, P = 0.040; 243 ± 37 vs 240 ± 27, P = NS, respectively). Isovolumetric relaxation and contraction times showed difference close to the significance limit (56 ± 19 vs 64 ± 23 ms, P = 0.055; 61 ± 16 vs 67 ± 16 ms, P = 0.062, respectively). TAPSE decreased significantly (2.62 ± 0.29 vs 2.41 ± 0.27 mm, P = 0.005).
E' velocity and TAPSE were sensitive to a volume reduction as little as 450 mL in healthy subjects. MPI index of the tricuspid annulus is less sensitive than E' and TAPSE but need much care under changing volume state. However S' and A' velocity and E'/A' ratio were found to be resistant to the effects of volume depletion.
我们旨在通过不同的超声心动图参数，研究献血模型中可控且有限的容量变化对健康成年人右心室（RV）功能的影响。
研究人群由71名健康受试者组成，他们均为献血志愿者，并在捐献450毫升血液前后进行了评估。评估了右心室流入道的脉冲波多普勒、三尖瓣侧环的组织多普勒以及三尖瓣环平面收缩期位移（TAPSE）。
流入道E速度显著降低（67.6±15.9对60.9±12.2，P = 0.006）。S'和A'速度未改变（分别为15.3±3.2对15.2±2.5厘米/秒，P =无统计学意义；14.1±3.3对13.4±3.1厘米/秒，P =无统计学意义），但E'显著降低（13.7±2.9对12.2±3.2厘米/秒，P = 0.011）。发现E'/A'比值和E/E'比值未改变（分别为1.0±0.3对1.0±0.4，P =无统计学意义；5.1±2对5.3±2，P =无统计学意义）。发现三尖瓣环心肌性能指数（MPI）升高，但从三尖瓣环获得的射血时间未改变（0.50±0.13对0.54±0.11，P = 0.040；243±37对240±27，P =无统计学意义）。等容舒张期和收缩期时间显示出接近显著性界限的差异（分别为56±19对64±23毫秒，P = 0.055；61±16对67±16毫秒，P = 0.062）。TAPSE显著降低（2.62±0.29对2.41±0.27毫米，P = 0.005）。
在健康受试者中，E'速度和TAPSE对低至450毫升的容量减少敏感。三尖瓣环的MPI指数比E'和TAPSE敏感性低，但在容量状态变化时需要格外关注。然而，发现S'和A'速度以及E'/A'比值对容量减少的影响具有抗性。
