Kühn Andreas, Meierhofer Christian, Rutz Tobias, Rondak Ina-Christine, Röhlig Christoph, Schreiber Christian, Fratz Sohrab, Ewert Peter, Vogt Manfred
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, Munich 80636, Germany.
Institute of Medical Statistics and Epidemiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
Eur Heart J Cardiovasc Imaging. 2016 Aug;17(8):930-5. doi: 10.1093/ehjci/jev243. Epub 2015 Oct 8.
Ebstein's anomaly (EA) is often associated with right ventricular (RV) dysfunction. Data on echocardiographic quantification of RV function are, however, rare. The aim of this study was to determine how non-volumetric echocardiographic indices and qualitative assessment of global systolic RV function correlate with cardiovascular magnetic resonance (CMR)-derived RV ejection fraction (EF).
We compared six echocardiographic indices and qualitative assessment of RV function with the gold standard CMR. A total of 49 unoperated patients with EA and a mean age of 32 ± 18 years were examined. Tricuspid annular plane systolic excursion, tissue Doppler myocardial velocities (peak S and IVA) and 2D strain and strain rate measures for the RV were compared with CMR-derived EF. Only 2D global longitudinal strain (2D-GLS), out of the six parameters investigated, showed a weak, although statistically significant correlation with CMR-derived RVEF (R = -0.4, P = 0.01). Using a cut-off value of -20.15, 2D-GLS sensitivity (77%) and specificity (46%) in detecting patients with a CMR-derived EF of <50% were comparable with qualitative assessment (sensitivity 77%, specificity 45%).
Overall echocardiographic parameters of RV function correlate poorly with CMR-derived EF in patients with EA. Only 2D global longitudinal RV strain correlated weakly with CMR-derived RVEF. However, the sensitivity and specificity for detecting RV dysfunction using 2D strain imaging were comparable with qualitative RV functional assessment.
埃布斯坦畸形（EA）常与右心室（RV）功能障碍相关。然而，关于超声心动图定量评估RV功能的数据却很少。本研究的目的是确定非容积性超声心动图指标及RV整体收缩功能的定性评估与心血管磁共振（CMR）得出的RV射血分数（EF）之间的相关性。
我们将六个超声心动图指标及RV功能的定性评估与金标准CMR进行了比较。共检查了49例未接受手术的EA患者，平均年龄为32±18岁。将三尖瓣环平面收缩期位移、组织多普勒心肌速度（峰值S和IVA）以及RV的二维应变和应变率测量值与CMR得出的EF进行了比较。在所研究的六个参数中，只有二维整体纵向应变（2D-GLS）与CMR得出的RVEF显示出微弱但具有统计学意义的相关性（R = -0.4，P = 0.01）。使用-20.15的临界值，2D-GLS在检测CMR得出的EF<50%的患者时的敏感性（77%）和特异性（46%）与定性评估相当（敏感性77%，特异性45%）。
EA患者中，RV功能的整体超声心动图参数与CMR得出的EF相关性较差。只有二维RV整体纵向应变与CMR得出的RVEF有微弱相关性。然而，使用二维应变成像检测RV功能障碍的敏感性和特异性与RV功能定性评估相当。
