Srinivasan Aparna, Kim Jiwon, Khalique Omar, Geevarghese Alexi, Rusli Melissa, Shah Tara, Di Franco Antonino, Alakbarli Javid, Goldburg Samantha, Rozenstrauch Meenakshi, Devereux Richard B, Weinsaft Jonathan W
Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
Echocardiography. 2017 Mar;34(3):348-358. doi: 10.1111/echo.13438. Epub 2017 Mar 1.
Echocardiography (echo)-based linear fractional shortening (FS) is widely used to assess left ventricular dysfunction (LV ), but has not been systematically tested for right ventricular dysfunction (RV ).
The population comprised LV patients with and without RV (EF<50%) on cardiac MRI (CMR): Echo included standard RV indices (fractional area change [FAC], TAPSE, S', and FS in parasternal long-axis (RV outflow tract [RV ]) and apical four-chamber views (width [RV ], length [RV ]).
A total of 168 patients underwent echo and CMR (3±3 days); FAC (46±9 vs 28±11), TAPSE (1.9±0.4 vs 1.5±0.3), and S' (11.4±2.3 vs 10.0±2.6, all P≤.001) were lower among RV patients, as were FS indices (RV 32±8 vs 17±10 | RV 40±11 vs 22±12 | RV 16±5 vs 9±4%; all P<.001). FS indices yielded similar magnitude of correlation with CMR RVEF (r=.73-.56) as did FAC (r=.70), which was slightly higher than TAPSE (r=.47) and S' (r=.31; all P<.001). FS indices decreased stepwise vs CMR RVEF tertiles, as did FAC (all P<.001). In multivariate analysis, FS in RV (regression coefficient .51 [CI 0.37-0.65]), RV (0.30 [0.19-0.41]), and RV (0.45 [0.20-0.71]; all P≤.001) was independently associated with CMR RVEF. FS indices yielded good overall diagnostic performance (AUC: RV 0.89 [CI 0.82-0.97] | RV 0.87 [0.78-0.96] | RV 0.80 [0.70-0.90]; all P<.001) for CMR-defined RV (RVEF<50%).
RV linear FS provides RV functional indices that parallel CMR RVEF. Parasternal long-axis RV width, four-chamber RV width, and length are independently associated with RVEF, supporting use of multiple FS indices for RV functional assessment.
基于超声心动图（echo）的线性缩短分数（FS）被广泛用于评估左心室功能障碍（LV），但尚未针对右心室功能障碍（RV）进行系统测试。
研究人群包括经心脏磁共振成像（CMR）检查有或无RV（射血分数<50%）的LV患者：超声心动图检查包括标准RV指标（面积变化分数[FAC]、三尖瓣环平面收缩期位移[TAPSE]、S'，以及胸骨旁长轴（RV流出道[RV]）和心尖四腔心切面的FS（RV宽度[RV]、长度[RV]）。
共有168例患者接受了超声心动图和CMR检查（间隔3±3天）；RV患者的FAC（46±9对28±11）、TAPSE（1.9±0.4对1.5±0.3）和S'（11.4±2.3对10.0±2.6，均P≤.001）较低，FS指标也较低（RV 32±8对17±10 | RV 40±11对22±12 | RV 16±5对9±4%；均P<.001）。FS指标与CMR右心室射血分数（RVEF）的相关性强度与FAC相似（r=.73-.56），略高于TAPSE（r=.47）和S'（r=.31；均P<.001）。FS指标随CMR RVEF三分位数呈逐步下降，FAC也是如此（均P<.001）。在多变量分析中，RV的FS（回归系数.51 [CI 0.37-0.65]）、RV（0.30 [0.19-0.41]）和RV（0.45 [0.20-0.71]；均P≤.001）与CMR RVEF独立相关。FS指标对CMR定义的RV（RVEF<50%）具有良好的总体诊断性能（AUC：RV 0.89 [CI 0.82-0.97] | RV 0.87 [0.78-0.96] | RV 0.80 [0.70-0.90]；均P<.001）。
RV线性FS提供了与CMR RVEF平行的RV功能指标。胸骨旁长轴RV宽度、四腔心RV宽度和长度与RVEF独立相关，支持使用多个FS指标进行RV功能评估。
