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经胸超声心动图对儿童先天性心脏病合并肺动脉高压患者右心室功能的定量评估

Quantitative evaluation of right ventricle function by transthoracic echocardiography in childhood congenital heart disease patients with pulmonary hypertension.

作者信息

Cevik Ayhan, Kula Serdar, Olgunturk Rana, Tunaoglu F Sedef, Oguz A Deniz, Pektas Ayhan, Saylan Berna

机构信息

Department of Pediatric Cardiology, Gazi University Medical Faculty Hospital, Ankara, Turkey.

出版信息

Echocardiography. 2012 Aug;29(7):840-8. doi: 10.1111/j.1540-8175.2012.01697.x. Epub 2012 Apr 11.

DOI:10.1111/j.1540-8175.2012.01697.x
PMID:22494051
Abstract

INTRODUCTION AND OBJECTIVE

The present study aims to quantitatively evaluate the right ventricle (RV) function by means of transthoracic echocardiography in normal children and childhood congenital heart disease patients with pulmonary hypertension.

PATIENTS AND METHODS

This study was conducted in a cohort including 40 healthy children and 30 pediatric patients with pulmonary hypertension who were diagnosed under close surveillance at the study center between October 2009 and November 2010.

RESULTS

Statistically significant differences were found between the patient and control groups for the right ventricle myocardial performance index (RVMPI), the left ventricle myocardial performance index (LVMPI), the tricuspid valve systolic flow velocity (Ts), the ratio of systolic pulmonary artery pressure to the right ventricle outflow tract systolic flow velocity time integral (sPAP/RVOT VTI), and the ratio of systolic pulmonary artery pressure to right ventricle outflow tract systolic flow velocity time integral × heart rate (sPAP/[RVOT VTI×HR]). When the children were divided into three groups based on their pulmonary vascular resistance significant differences emerged that predicted an increasing severity of RV dysfunction. Significant differences were also observed for the RVMPI, the LVMPI, and the Ts as well as for echocardiographic pulmonary flow (Qp) and systemic flow (Qs).

DISCUSSION

The present study demonstrates that echocardiographic parameters can be used for the quantitative detection of RV dysfunction in childhood congenital heart disease patients with high pulmonary artery pressure (systolic, diastolic, and mean) or pulmonary vascular resistance.

摘要

引言与目的

本研究旨在通过经胸超声心动图对正常儿童以及患有肺动脉高压的儿童先天性心脏病患者的右心室(RV)功能进行定量评估。

患者与方法

本研究纳入了一个队列,其中包括40名健康儿童以及30名患有肺动脉高压的儿科患者,这些患者于2009年10月至2010年11月在研究中心接受密切监测并被确诊。

结果

在患者组与对照组之间,右心室心肌做功指数(RVMPI)、左心室心肌做功指数(LVMPI)、三尖瓣收缩期血流速度(Ts)、收缩期肺动脉压与右心室流出道收缩期血流速度时间积分的比值(sPAP/RVOT VTI)以及收缩期肺动脉压与右心室流出道收缩期血流速度时间积分×心率的比值(sPAP/[RVOT VTI×HR])存在统计学显著差异。当根据肺血管阻力将儿童分为三组时,出现了预测右心室功能障碍严重程度增加的显著差异。在RVMPI、LVMPI和Ts以及超声心动图肺血流量(Qp)和体循环血流量(Qs)方面也观察到了显著差异。

讨论

本研究表明,超声心动图参数可用于定量检测肺动脉高压(收缩期、舒张期和平均压)或肺血管阻力较高的儿童先天性心脏病患者的右心室功能障碍。

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引用本文的文献

1
Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction.经胸超声心动图在小儿肺动脉高压和心室功能障碍评估中的应用
Pulm Circ. 2016 Mar;6(1):15-29. doi: 10.1086/685051.
2
Repair of congenital heart disease with associated pulmonary hypertension in children: what are the minimal investigative procedures? Consensus statement from the Congenital Heart Disease and Pediatric Task Forces, Pulmonary Vascular Research Institute (PVRI).儿童先天性心脏病合并肺动脉高压的修复:哪些是最小的检查程序?先天性心脏病和儿科工作组、肺血管研究协会(PVRI)的共识声明。
Pulm Circ. 2014 Jun;4(2):330-41. doi: 10.1086/675995.