Iacoviello Massimo, Citarelli Gaetano, Antoncecchi Valeria, Romito Roberta, Monitillo Francesco, Leone Marta, Puzzovivo Agata, Lattarulo Maria Silvia, Rizzo Caterina, Caldarola Pasquale, Ciccone Marco Matteo
Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.
School of Cardiology, University of Bari, Bari, Italy.
Echocardiography. 2016 Jul;33(7):992-1000. doi: 10.1111/echo.13199. Epub 2016 Feb 11.
The assessment of right ventricular (RV) function still remains a challenge. Two-dimensional (2D) speckle tracking has recently been proposed to evaluate right ventricular function by analyzing myocardial deformation. The aim of this study was to evaluate the role of 2D systolic strain measures of RV in predicting mortality in patients with chronic heart failure (HF). We enrolled 332 outpatients in a stable clinical condition and in conventional therapy. A right ventricular-focused four-chamber view was analyzed by 2D speckle tracking to evaluate the global longitudinal strain of RV (RV-GLS) and the strain of RV free wall (RV-fwLS). During a mean follow-up of 36 ± 26 months, 64 patients died. Both RV-GLS and RV-fwLS were associated with all-cause mortality in univariate (HR: 1.16; 95% CI: 1.10-1.23; P < 0.001; C-index: 0.72; and HR: 1.10; 95% CI: 1.06-1.15; P < 0.001; C-index: 0.68, respectively) as well as multivariate analysis (HR: 1.13; 95% CI: 1.05-1.21; P:0.001; C-index: 0.85; and HR: 1.07; 95% CI: 1.02-1.12; P:0.004; C-index: 0.84, respectively). In conclusion, our findings demonstrate the role of RV 2D strain measures to independently predict mortality. These data highlight the clinical usefulness of this echocardiographic approach in the daily management of HF outpatients.
右心室（RV）功能的评估仍然是一项挑战。最近有人提出通过分析心肌变形，利用二维（2D）斑点追踪技术来评估右心室功能。本研究的目的是评估右心室二维收缩期应变测量在预测慢性心力衰竭（HF）患者死亡率方面的作用。我们纳入了332例临床状况稳定且接受常规治疗的门诊患者。通过二维斑点追踪技术分析右心室聚焦四腔视图，以评估右心室整体纵向应变（RV-GLS）和右心室游离壁应变（RV-fwLS）。在平均36±26个月的随访期间，64例患者死亡。RV-GLS和RV-fwLS在单变量分析（HR：1.16；95%CI：1.10 - 1.23；P < 0.001；C指数：0.72；以及HR：1.10；95%CI：1.06 - 1.15；P < 0.001；C指数：0.68）和多变量分析（HR：1.13；95%CI：1.05 - 1.21；P：0.001；C指数：0.85；以及HR：1.07；95%CI：1.02 - 1.12；P：0.004；C指数：0.84）中均与全因死亡率相关。总之，我们的研究结果表明右心室二维应变测量在独立预测死亡率方面的作用。这些数据突出了这种超声心动图方法在心力衰竭门诊患者日常管理中的临床实用性。
