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经皮右冠状动脉慢性完全闭塞再通成功后右心室功能的超声心动图评估。

Echocardiographic evaluation of right ventricular functions after successful percutaneous recanalization of right coronary artery chronic total occlusions.

机构信息

Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Heart-Education and Research Hospital, Istanbul, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2013 Apr;17(7):917-22.

Abstract

BACKGROUND

No data exist on regarding possible improvement will occur in right ventricular (RV) functions after successful recanalization of right coronary artery chronic total occlusions (RCA CTOs).

AIM

Our aim was to evaluate the revascularization induced changes in RV functions by novel echocardiographic techniques like tissue Doppler imaging (TDI) and two dimensional speckle tracking echocardiography (2DSTE).

PATIENTS AND METHODS

Forty-one consecutive successfully recanalized patients with RCA CTOs were included in our study. All included patients underwent standard echocardiography with TDI and 2DSTE to assess RV function before procedure and repeated after 24 hours and 1 month.

RESULTS

There were no significant changes in tricuspid annular plane systolic excursion, systolic myocardial velocities, and fractional area change values. However, RV global longitudinal strain and systolic strain rate values showed a significant increase at 24 hours after percutaneous coronary intervention compared to baseline (-23.6±4.1% vs. -19.7±3.9%, p < 0.001 and -1.55±0.18s-1 vs. -1.18±0.17s-1, p < 0.001, respectively). Moreover, improvement of the RV functions in patients with RCA CTOs was further suggested by the higher RV isovolumic acceleration values at 1-month compared with baseline (2.29±0.62 vs. 2.05±0.5 m/s2, p = 0.014).

CONCLUSIONS

TDI derived isovolumic acceleration and 2DSTE derived global longitudinal strain and systolic strain rate values showed improvement in RV functions after successful percutaneous recanalization of RCACTOs suggesting viability of RV in chronic ischemia.

摘要

背景

关于右冠状动脉慢性完全闭塞(RCA CTO)成功再通后右心室(RV)功能是否会有所改善,目前尚无相关数据。

目的

我们旨在通过组织多普勒成像(TDI)和二维斑点追踪超声心动图(2DSTE)等新型超声心动图技术评估 RV 功能的再血管化诱导变化。

患者和方法

本研究共纳入 41 例成功再通的 RCA CTO 患者。所有纳入的患者均接受标准超声心动图检查,包括 TDI 和 2DSTE,以评估介入治疗前、治疗后 24 小时和 1 个月的 RV 功能。

结果

三尖瓣环平面收缩期位移、收缩心肌速度和射血分数值没有明显变化。然而,与基线相比,经皮冠状动脉介入治疗后 24 小时 RV 整体纵向应变和收缩应变率值显著增加(-23.6±4.1%比-19.7±3.9%,p<0.001;-1.55±0.18s-1比-1.18±0.17s-1,p<0.001)。此外,与基线相比,1 个月时 RV 等容加速度值的升高进一步提示 RCA CTO 患者 RV 功能的改善(2.29±0.62 比 2.05±0.5 m/s2,p=0.014)。

结论

TDI 衍生的等容加速度值和 2DSTE 衍生的整体纵向应变和收缩应变率值提示成功经皮再通 RCA CTO 后 RV 功能改善,提示 RV 在慢性缺血中具有活力。

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