D'Andrea Antonello, Vriz Olga, Carbone Andreina, Ferrara Francesco, Di Maio Marco, Cocchia Rosangela, Tagliamonte Gianluigi, Acri Edwige, Driussi Caterina, Pezzullo Enrica, Citro Rodolfo, Cittadini Antonio, Calabrò Raffaele, Giovanna Russo Maria, Bossone Eduardo
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Department of Cardiology and Emergency Medicine of San Antonio Hospital, San Daniele del Friuli, Udin, Italy.
J Cardiol. 2017 Oct;70(4):387-395. doi: 10.1016/j.jjcc.2016.12.005. Epub 2017 Mar 18.
Doppler echocardiography is ideally suited for assessment of diastolic function, being widely available, non-invasive, and less expensive than other techniques. However, data regarding age- and gender-matched reference values of right ventricular diastolic function are limited. This study aims to explore the physiologic variations of right ventricle (RV) diastolic function in a large cohort of healthy adults, and to investigate clinical and echocardiographic correlates.
From June 2007 to February 2014, 1168 healthy Caucasian subjects [mean age 45.1±15.6 years, range 16-92; 555 (47.5%) men] underwent comprehensive transthoracic echocardiography (TTE) following current guidelines. The following RV main diastolic measurements were measured: peak early inflow velocity (E), annular both early (e') and atrial (a') velocities, E/e' ratio.
RV E/e' constantly increases with age in females, but do not change substantially in males. RV E/A constantly decreases with age in both genders. Stepwise multiple linear regression analysis underlined a close significant association of RV diastolic function with both right and left heart morphologic measurements (right atrial area, RV diameters, left atrial volume) and functional indexes (TAPSE, RV tissue Doppler peak systolic velocity, left ventricular E/Ee'), as well as with indexes of increased pulmonary resistance.
Our data highlight the potential usefulness of different normal reference values according to the age and gender to correctly evaluate RV diastolic function. Differences in terms of demographic and anthropometric parameters could be useful to avoid potential misclassification of RV diastolic function when based on dichotomously suggested normal cut-off values.
多普勒超声心动图非常适合评估舒张功能，它广泛可用、无创且比其他技术成本更低。然而，关于右心室舒张功能的年龄和性别匹配参考值的数据有限。本研究旨在探讨一大群健康成年人右心室（RV）舒张功能的生理变化，并研究临床和超声心动图相关性。
从2007年6月至2014年2月，1168名健康的白种人受试者[平均年龄45.1±15.6岁，范围16 - 92岁；555名（47.5%）男性]按照现行指南接受了全面的经胸超声心动图（TTE）检查。测量了以下右心室主要舒张参数：早期峰值流入速度（E）、瓣环早期（e'）和心房（a'）速度、E/e'比值。
女性的右心室E/e'随年龄持续增加，而男性变化不大。男女两性的右心室E/A均随年龄持续降低。逐步多元线性回归分析强调，右心室舒张功能与左右心形态学测量值（右心房面积、右心室直径、左心房容积）和功能指标（三尖瓣环平面收缩期位移、右心室组织多普勒峰值收缩速度、左心室E/Ee'）以及肺阻力增加指标密切相关。
我们的数据强调了根据年龄和性别采用不同正常参考值对正确评估右心室舒张功能的潜在有用性。人口统计学和人体测量学参数的差异可能有助于避免基于二分法建议的正常临界值对右心室舒张功能进行潜在的错误分类。
