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在无右心室功能障碍或轻度右心室功能障碍的慢性心力衰竭患者中,应用超声心动图对右心室功能进行定量分析:与心脏磁共振成像的比较

Quantitative analysis of right ventricular (RV) function with echocardiography in chronic heart failure with no or mild RV dysfunction: comparison with cardiac magnetic resonance imaging.

作者信息

Vizzardi Enrico, Bonadei Ivano, Sciatti Edoardo, Pezzali Natalia, Farina Davide, D'Aloia Antonio, Metra Marco

机构信息

Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

出版信息

J Ultrasound Med. 2015 Feb;34(2):247-55. doi: 10.7863/ultra.34.2.247.

Abstract

OBJECTIVES

Right ventricular (RV) performance parameters (tricuspid annular plane systolic excursion, systolic longitudinal velocity on tissue Doppler imaging, fractional area change, and tissue and 2-dimensional [2D] strain on the right free wall) have been validated. In comparative studies, they have been correlated with the prognosis of patients with heart failure on radionuclide ventriculography and thermodilution in right heart catheterization. This study aimed to evaluate RV systolic function in patients with heart failure with no or mild RV dysfunction and correlate the above-mentioned echocardiographic parameters with the magnetic resonance imaging (MRI)-calculated RV ejection fraction (RVEF), stroke volume, end-diastolic volume, and end-systolic volume.

METHODS

Standard and pulsed Doppler tissue echocardiography and MRI were performed in 31 patients with New York Heart Association functional class II and III chronic heart failure.

RESULTS

A high correlation between tricuspid annular plane systolic excursion, systolic longitudinal velocity, tissue strain, and 2D strain was noted, whereas the fractional area change did not correlate with any other parameter. The RVEF correlated with tricuspid annular plane systolic excursion, systolic longitudinal velocity, and tissue and 2D strain (all P< .01); under linear regression analysis, the 4 parameters independently correlated with RVEF.

CONCLUSIONS

Echocardiographic RV performance parameters (tricuspid annular plane systolic excursion, systolic longitudinal velocity, tissue strain, and 2D strain) correlated with the MRI-calculated RVEF and overall predicted it. In particular, RV 2D strain and tissue strain were good markers for RV longitudinal motions. These echocardiographic parameters are easily obtained and may give important information about RV function for evaluation and prognostic stratification of patients with heart failure.

摘要

目的

右心室(RV)功能参数(三尖瓣环平面收缩期位移、组织多普勒成像的收缩期纵向速度、面积变化分数以及右心室游离壁的组织应变和二维[2D]应变)已得到验证。在比较研究中,它们与心力衰竭患者放射性核素心室造影和右心导管热稀释法的预后相关。本研究旨在评估无或轻度RV功能障碍的心力衰竭患者的RV收缩功能,并将上述超声心动图参数与磁共振成像(MRI)计算的RV射血分数(RVEF)、每搏输出量、舒张末期容积和收缩末期容积相关联。

方法

对31例纽约心脏协会心功能II级和III级的慢性心力衰竭患者进行了标准和脉冲多普勒组织超声心动图及MRI检查。

结果

观察到三尖瓣环平面收缩期位移、收缩期纵向速度、组织应变和2D应变之间存在高度相关性,而面积变化分数与任何其他参数均无相关性。RVEF与三尖瓣环平面收缩期位移、收缩期纵向速度以及组织和2D应变相关(均P<0.01);在线性回归分析中,这4个参数与RVEF独立相关。

结论

超声心动图RV功能参数(三尖瓣环平面收缩期位移、收缩期纵向速度、组织应变和2D应变)与MRI计算的RVEF相关并能总体预测它。特别是,RV 2D应变和组织应变是RV纵向运动的良好标志物。这些超声心动图参数易于获得,可为心力衰竭患者的评估和预后分层提供有关RV功能的重要信息。

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