Bech-Hanssen Odd, Pergola Valeria, Al-Admawi Mohammed, Fadel Bahaa M, Di Salvo Giovanni
a Heart Centre, King Faisal Specialist Hospital & Research Centre , Riyadh , Kingdom of Saudi Arabia.
b Department of Clinical Physiology , Institute of Medicine at the Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden.
Scand Cardiovasc J. 2016;50(1):42-51. doi: 10.3109/14017431.2015.1091946. Epub 2015 Oct 14.
In heart transplantation (HTx) with the bicaval technique the whole right atrium (RA) is donor tissue while the left atrium (LA) consists of both donor and recipient tissue. The aims of the study were to describe atrial function in comparison with healthy controls and to identify determinants of dysfunction.
Forty-three patients and 30 controls were retrospectively included. Echocardiography was performed within 24 h of right heart catheterization (RHC) (HTx recipients).
The peak longitudinal atrial systolic strain (ɛ) described the atrial reservoir function. The LA and RA reservoir function were reduced versus controls (LA-ɛ 18 ± 8 versus 44 ± 10%; RA-ɛ 22 ± 10 versus 69 ± 17%, p < 0.001). There were moderate relationships between atrial-ɛ and ventricular filling pressure (r = -0.64 for LA-ɛ; r = -0.57 for RA-ɛ). In a multiple regression analysis the LA-ɛ was determined by pulmonary capillary wedge pressure (PCWP) and LA minimum volume index (r = -0.71) while RA-ɛ was dependent on the right ventricular ɛ (r = -0.77).
Atrial reservoir function is markedly reduced in HTx recipients related to elevated PCWP and LA-enlargement in the LA and in the RA impaired longitudinal right ventricular function.
在采用双腔静脉技术的心脏移植（HTx）中，整个右心房（RA）为供体组织，而左心房（LA）由供体和受体组织组成。本研究的目的是与健康对照相比描述心房功能，并确定功能障碍的决定因素。
回顾性纳入43例患者和30例对照。在右心导管检查（RHC）（HTx受者）后24小时内进行超声心动图检查。
纵向心房收缩峰值应变（ɛ）描述了心房的储存功能。与对照组相比，左心房和右心房的储存功能降低（左心房-ɛ 18±8%对44±10%；右心房-ɛ 22±10%对69±17%，p<0.001）。心房-ɛ与心室充盈压之间存在中度相关性（左心房-ɛ的r=-0.64；右心房-ɛ的r=-0.57）。在多元回归分析中，左心房-ɛ由肺毛细血管楔压（PCWP）和左心房最小容积指数决定（r=-0.71），而右心房-ɛ取决于右心室ɛ（r=-0.77）。
HTx受者的心房储存功能明显降低，与PCWP升高、左心房扩大以及右心房纵向右心室功能受损有关。
