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通过右心室纵向和径向收缩评估的与几何形状相关的右心室收缩功能

Geometry-Related Right Ventricular Systolic Function Assessed by Longitudinal and Radial Right Ventricular Contractions.

作者信息

Hashimoto Ikuo, Watanabe Kazuhiro

机构信息

Department of Pediatrics, Toyama City Hospital, Toyama City, Japan.

出版信息

Echocardiography. 2016 Feb;33(2):299-306. doi: 10.1111/echo.13039.

Abstract

The aim of our study was to evaluate the geometry-related right ventricular (RV) systolic function under normal hemodynamics by assessing the longitudinal and the radial RV contractions in children. We examined 953 healthy children. We measured tricuspid annular plane systolic excursion (TAPSE), RV anterior wall displacement from the interventricular septum (RVWD), and RV to left ventricular diameter ratio (RV/LV ratio) using M-mode echocardiography. The z-values were calculated as geometrical parameters of the TAPSE (z-TAPSE), the RVWD (z-RVWD), and the RV/LV ratio (z-RV/LV). The RV stroke volume (RVSV) was measured using Doppler echocardiography and standardized using the z-value (z-RVSV). The z-TAPSE was no or weakly negatively correlated with both the z-RVWD (r = -0.18, P < 0.0001) and the z-RV/LV (r = -0.12, P < 0.0001). In contrast, the z-RV/LV correlated positively with the z-RVWD (r = 0.61, P < 0.0001). The z-RVSV correlated only with the z-TAPSE (r = 0.30, P < 0.0001). Although the radial RV motion increases with the progression of RV dilatation, the RVSV is not associated with radial RV motion. In contrast, the RVSV relates to the longitudinal RV motion independently of the radial RV motion under the normal physiological condition. We presume that the RV contraction patterns change related to the RV geometry under various hemodynamic conditions.

摘要

我们研究的目的是通过评估儿童右心室(RV)的纵向和径向收缩,在正常血流动力学状态下评估与几何形状相关的右心室收缩功能。我们检查了953名健康儿童。我们使用M型超声心动图测量三尖瓣环平面收缩期位移(TAPSE)、右心室前壁与室间隔的位移(RVWD)以及右心室与左心室直径比(RV/LV比)。计算z值作为TAPSE(z-TAPSE)、RVWD(z-RVWD)和RV/LV比(z-RV/LV)的几何参数。使用多普勒超声心动图测量右心室每搏输出量(RVSV)并使用z值进行标准化(z-RVSV)。z-TAPSE与z-RVWD(r = -0.18,P < 0.0001)和z-RV/LV(r = -0.12,P < 0.0001)均无或呈弱负相关。相比之下,z-RV/LV与z-RVWD呈正相关(r = 0.61,P < 0.0001)。z-RVSV仅与z-TAPSE相关(r = 0.30,P < 0.0001)。尽管随着右心室扩张的进展,右心室的径向运动增加,但RVSV与右心室的径向运动无关。相反,在正常生理条件下,RVSV与右心室的纵向运动相关,而与右心室的径向运动无关。我们推测在各种血流动力学条件下,右心室的收缩模式会因右心室几何形状的改变而发生变化。

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