Koestenberger Martin, Nagel Bert, Avian Alexander, Ravekes William, Sorantin Erich, Cvirn Gerhard, Beran Elisabeth, Halb Verena, Gamillscheg Andreas
Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Auenbruggerplatz 34/2, Graz, Austria.
Congenit Heart Dis. 2012 May-Jun;7(3):250-8. doi: 10.1111/j.1747-0803.2012.00655.x. Epub 2012 Apr 12.
The tricuspid annular plane systolic excursion (TAPSE), as echocardiographic index to assess right ventricular (RV) systolic function, has not been investigated thoroughly in children and young adults with tetralogy of Fallot (TOF) and pulmonary artery hypertension secondary to congenital heart disease (PAH-CHD).
TAPSE values of 49 patients with PAH-CHD and 156 patients with TOF were compared with age-matched normal subjects. TAPSE values were also compared with RV ejection fraction (RVEF) and RV indexed end-diastolic volume (RVEDVi) determined by magnetic resonance imaging in PAH-CHD and TOF patients.
Patients with a PAH-CHD showed a positive correlation between TAPSE with RVEF (r= 0.81; P < 0.001) and a negative correlation between TAPSE with RVEDVi (r=-0.67; P < 0.001). Similarly, in our TOF patients, a positive correlation between TAPSE with RVEF (r= 0.65; P < 0.001) and a negative correlation between TAPSE with RVEDVi (r=-0.42; P < 0.001) was seen.
Significant pressure overload in PAH-CHD patients and volume overload in TOF patients lead to a decreased systolic RV function, determined by TAPSE and magnetic resonance imaging and to increased RVEDVi values, determined by MRI, with time.
三尖瓣环平面收缩期位移(TAPSE)作为评估右心室(RV)收缩功能的超声心动图指标,在患有法洛四联症(TOF)和先天性心脏病继发肺动脉高压(PAH-CHD)的儿童和年轻成人中尚未得到充分研究。
将49例PAH-CHD患者和156例TOF患者的TAPSE值与年龄匹配的正常受试者进行比较。还将PAH-CHD和TOF患者的TAPSE值与通过磁共振成像测定的右心室射血分数(RVEF)和右心室指数舒张末期容积(RVEDVi)进行比较。
PAH-CHD患者中,TAPSE与RVEF呈正相关(r = 0.81;P < 0.001),TAPSE与RVEDVi呈负相关(r = -0.67;P < 0.001)。同样,在我们的TOF患者中,TAPSE与RVEF呈正相关(r = 0.65;P < 0.001),TAPSE与RVEDVi呈负相关(r = -0.42;P < 0.001)。
PAH-CHD患者的显著压力超负荷和TOF患者的容量超负荷导致右心室收缩功能下降,这由TAPSE和磁共振成像确定,并且随着时间的推移,由MRI确定的RVEDVi值增加。