Vizzardi Enrico, D'Aloia Antonio, Bordonali Tania, Bugatti Silvia, Piovanelli Barbara, Bonadei Ivano, Quinzani Filippo, Rovetta Riccardo, Vaccari Alberto, Curnis Antonio, Dei Cas Livio
Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Study of Brescia, Brescia, Italy.
Echocardiography. 2012 Aug;29(7):773-8. doi: 10.1111/j.1540-8175.2012.01703.x. Epub 2012 Apr 11.
The ventricular myocardial performance index (MPI) is a feasible echocardiographic parameter for the evaluation of patients with chronic heart failure (CHF). The long-term prognostic role of right ventricular MPI (RV MPI) has been already assessed in patients with more advanced CHF but data are lacking in moderate CHF. The aim of the study is to evaluate the possible prognostic role of RV MPI in moderate CHF patients compared to others traditional RV parameters.
From 2003 to 2004 we enrolled 95 consecutive NYHA class II CHF patients (65 males and 30 females), with the mean age of 66 ± 11 years with left ventricular ejection fraction (LVEF) <40%, on optimal medical treatment. All patients were evaluated clinically and by echocardiography with a follow-up of 5 years (combined end point: cardiovascular mortality and hospitalization for HF).
RV MPI was 0.45 ± 0.36, tricuspid annular plane systolic excursion was 21 ± 8 mm, RV fractional area change was 42 ± 12%, systolic pulmonary artery pressure was 33 ± 9 mmHg, and acceleration time of pulmonic flow was 115.5 + 22.62 msec. After the 5 year follow-up the total mortality was 24.2% and HF hospitalization rate was 33%. At Cox multivariate analysis only an RV MPI superior to median value (>0.38) and tricuspid annular plane systolic excursion inferior to median value (<18 mm) had shown a significant prognostic role.
The RV MPI in a population of moderate CHF showed to have a more long-term powerful prognostic value than other conventional and traditional echocardiographic right ventricular functional parameters.
心室心肌性能指数（MPI）是评估慢性心力衰竭（CHF）患者的一个可行的超声心动图参数。右心室MPI（RV MPI）的长期预后作用已在病情更严重的CHF患者中进行了评估，但在中度CHF患者中缺乏相关数据。本研究的目的是评估与其他传统右心室参数相比，RV MPI在中度CHF患者中的可能预后作用。
从2003年至2004年，我们连续纳入了95例纽约心脏协会（NYHA）心功能II级的CHF患者（65例男性和30例女性），平均年龄为66±11岁，左心室射血分数（LVEF）<40%，接受最佳药物治疗。所有患者均接受临床评估和超声心动图检查，并进行了5年的随访（联合终点：心血管死亡和因心力衰竭住院）。
RV MPI为0.45±0.36，三尖瓣环平面收缩期位移为21±8mm，右心室面积变化分数为42±12%，收缩期肺动脉压为33±9mmHg，肺动脉血流加速时间为1,15.5 + 22.62毫秒。5年随访后，总死亡率为24.2%，心力衰竭住院率为33%。在Cox多变量分析中，只有RV MPI高于中位数（>0.38）和三尖瓣环平面收缩期位移低于中位数（<18mm）显示出显著的预后作用。
在中度CHF人群中，RV MPI显示出比其他传统的超声心动图右心室功能参数更具长期强大的预后价值。
