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[二维超声心动图在评估肺动脉高压患者疾病严重程度中的价值]

[Value of Two Dimensional Echocardiography for Assessment of Disease Severity in Patients With Pulmonary Hypertension].

作者信息

Kyzymly A V, Ryzhkov A V, Simakova M A, Kozlyonok A V, Naimushin A V, Moiseeva O M

机构信息

1Almazov Federal North-West Medical Research Centre, Saint-Petersburg, Russia; 2Institute of Translational Medicine ITMO University, St-Petersburg, Russia.

出版信息

Kardiologiia. 2016 Jan;56(1):25-30. doi: 10.18565/cardio.2016.1.25-30.

Abstract

AIM

To carry out complex assessment of the right ventricular (RV) function with two-dimensional echocardiography (2D-EchoCG) for detection of most informative markers of the disease severity in patients with pulmonary hypertension (PH).

MATERIAL AND METHODS

We examined 63 patients with PH (38 with idiopathic PH, 7 with corrected congenital heart defects, 6 with systemic scleroderma, 12 with chronic inoperable thromboembolic PY). Examination included right heart catheterization, 2D-EchoCG, and cardiac magnetic resonance tomography (MRT).

RESULTS

2D-EchoCG revealed dilation of right chambers of the heart, hypertrophy of RV anterior wall, increase of ratio of right to left ventricular end-diastolic dimensions (RV:LV), reduction of LV stroke volume, diminution of amplitude and velocity of tricuspid annular plane systolic excursion, and significant increase of myocardial performance index Tei. MRT data evidenced for lowering of RV ejection fraction. Canonical correlation was found between integral characteristic of 2D-EchoCG and integral hemodynamic characteristic (r=0.77; p=0.007). We also determined threshold values of RV: LV to be used for stratification of risk in patients with PH.

CONCLUSION

In patienns with PH calculation of simple 2D-EchoCG parameters provides information important for determination of disease severity, selection of optimal method of treatment, and monitoring of patients condition.

摘要

目的

采用二维超声心动图(2D-EchoCG)对右心室(RV)功能进行综合评估,以检测肺动脉高压(PH)患者疾病严重程度的最具信息量的标志物。

材料与方法

我们检查了63例PH患者(38例特发性PH,7例先天性心脏病矫正术后,6例系统性硬化症,12例慢性不可手术的血栓栓塞性PH)。检查包括右心导管检查、2D-EchoCG和心脏磁共振断层扫描(MRT)。

结果

2D-EchoCG显示右心腔扩张、RV前壁肥厚、右心室与左心室舒张末期内径比值(RV:LV)增加、左心室搏出量减少、三尖瓣环平面收缩期位移幅度和速度降低以及心肌性能指数Tei显著增加。MRT数据证明RV射血分数降低。发现2D-EchoCG的综合特征与综合血流动力学特征之间存在典型相关性(r = 0.77;p = 0.007)。我们还确定了用于PH患者风险分层的RV:LV阈值。

结论

对于PH患者,计算简单的2D-EchoCG参数可提供对确定疾病严重程度、选择最佳治疗方法和监测患者病情至关重要的信息。

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