First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
Hellenic J Cardiol. 2013 Jan-Feb;54(1):32-8.
The aim of the present study was to examine the value of the right atrial volume index (RAVI) as predictor of functional capacity in patients with heart failure.
A total of 51 patients with stable chronic heart failure of ischaemic or non-ischaemic aetiology were prospectively enrolled. The systolic function of the right ventricle was quantified using the tricuspid annular plane systolic excursion (TAPSE). Right atrial volume was measured in the apical 4-chamber view and was indexed to body surface area. The functional capacity was assessed by the Duke Activity Status Index (DASI).
Patients with a low functional capacity (DASI<10) had lower TAPSE (1.4 ± 0.3 cm versus 2.0 ± 0.4 cm, p<0.001), higher RAVI (42 ± 15 ml/m(2) versus 22 ± 9 ml/m(2), p<0.001), higher estimated right ventricular systolic pressure (61 ± 13 mmHg versus 40 ± 16 mmHg, p<0.001), larger right ventricular end-diastolic diameter (4.7 ± 0.8 cm versus 3.6 ± 0.7 cm, p<0.001) and lower left ventricular ejection fraction (26 ± 6% versus 30 ± 7%, p=0.022). Multivariate analysis revealed that TAPSE was the single independent predictor of DASI. In the subgroup of patients with reduced right ventricular systolic function (TAPSE<2 cm), RAVI was the single independent predictor of low DASI. In the overall population RAVI=30.6 ml/m(2) had 75% sensitivity and 83% specificity in predicting DASI<10. Within the subgroup of patients with TAPSE<2 cm, RAVI=30.6 ml/m(2) had better sensitivity and specificity (79% and 90% respectively) in predicting DASI<10.
Increased right atrial volume index predicts low functional capacity quantified by the Duke Activity Status Index in patients with stable chronic heart failure.
本研究旨在探讨右心房容积指数（RAVI）作为预测心力衰竭患者功能能力的价值。
前瞻性纳入 51 例稳定的慢性缺血性或非缺血性病因心力衰竭患者。使用三尖瓣环平面收缩期位移（TAPSE）定量评估右心室收缩功能。在心尖四腔心切面测量右心房容积，并按体表面积指数化。功能能力通过杜克活动状态指数（DASI）评估。
功能能力低（DASI<10）的患者 TAPSE 较低（1.4±0.3cm 比 2.0±0.4cm，p<0.001），RAVI 较高（42±15ml/m2 比 22±9ml/m2，p<0.001），估计右心室收缩压较高（61±13mmHg 比 40±16mmHg，p<0.001），右心室舒张末期直径较大（4.7±0.8cm 比 3.6±0.7cm，p<0.001），左心室射血分数较低（26±6%比 30±7%，p=0.022）。多变量分析显示，TAPSE 是 DASI 的唯一独立预测因子。在右心室收缩功能降低（TAPSE<2cm）的患者亚组中，RAVI 是 DASI 低的唯一独立预测因子。在总体人群中，RAVI=30.6ml/m2 预测 DASI<10 的敏感性为 75%，特异性为 83%。在 TAPSE<2cm 的患者亚组中，RAVI=30.6ml/m2 预测 DASI<10 的敏感性和特异性分别为 79%和 90%。
稳定的慢性心力衰竭患者右心房容积指数增加可预测杜克活动状态指数量化的低功能能力。
