Cohen Scott, Gaddam Sainath, Gemignani Anthony, Wu Wen-Chih, Sharma Satish, Choudhary Gaurav
Vascular Research Laboratory, Providence VA Medical Center, Providence, Rhode Island 02908, USA.
Echocardiography. 2013 May;30(5):542-50. doi: 10.1111/echo.12099. Epub 2013 Jan 11.
While left ventricular (LV) diastolic function (E/e') is related to functional capacity in patients with atrial fibrillation (AF), the underlying mechanism is unclear. Right ventricular (RV) function is related to prognosis in various diseases, however, its relationship with LV diastolic function is not well-studied. We sought to examine the reliability of echocardiographic indices of RV function in AF, the relationship between LV diastolic function and RV function, and the relationship between RV function and 6MWT distance in ambulatory patients with AF.
We designed a retrospective study evaluating 52 veterans with AF and preserved LV ejection fraction (LVEF) who underwent echocardiography and 6MWT at scheduled visits throughout 1 year. We performed pairwise correlation to evaluate reproducibility of echocardiographic indices of RV function measured 1 week apart. Multiple regression was used to assess the association of indices of RV function to LV diastolic function and functional capacity.
Most RV function indices had good to excellent correlation between 2 visits 1 week apart (coefficient 0.50-0.81) with test-retest variations of <6%, except for tricuspid annular plane systolic excursion (TAPSE), which had a significant variation in 9%. TAPSE, RV S' and RV e' were significantly related to LV diastolic function after adjusting for RV systolic pressure. After further adjustment for comorbidities, only RV S' and RV e' remained significantly related to 6MWT.
RV tissue Doppler measurements (S' and e') had good reproducibility and were independently related to LV diastolic function and 6MWT in men with AF and preserved LVEF.
虽然左心室(LV)舒张功能(E/e')与心房颤动(AF)患者的功能能力有关,但其潜在机制尚不清楚。右心室(RV)功能与多种疾病的预后相关,然而,其与LV舒张功能的关系尚未得到充分研究。我们试图研究AF患者中RV功能超声心动图指标的可靠性、LV舒张功能与RV功能之间的关系,以及AF门诊患者RV功能与6分钟步行试验(6MWT)距离之间的关系。
我们设计了一项回顾性研究,评估52例LV射血分数(LVEF)保留的AF退伍军人,他们在1年的定期随访中接受了超声心动图检查和6MWT。我们进行了成对相关性分析,以评估相隔1周测量的RV功能超声心动图指标的可重复性。多元回归用于评估RV功能指标与LV舒张功能和功能能力之间的关联。
除三尖瓣环平面收缩期位移(TAPSE)外,大多数RV功能指标在相隔1周的两次检查之间具有良好至极好的相关性(系数0.50 - 0.81),重测变异<6%,而TAPSE的变异率为9%,具有显著性。在调整RV收缩压后,TAPSE、RV S'和RV e'与LV舒张功能显著相关。在进一步调整合并症后,只有RV S'和RV e'与6MWT仍显著相关。
RV组织多普勒测量值(S'和e')具有良好的可重复性,并且在LVEF保留的AF男性中与LV舒张功能和6MWT独立相关。