Allam Lamyaa Elsayed, Onsy Ahmed Mohammed, Ghalib Hylan Ahmed
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Cardiovasc Echogr. 2017 Apr-Jun;27(2):52-58. doi: 10.4103/2211-4122.203557.
Echocardiographic right ventricular (RV) function assessment is difficult and still a gray area despite rapid advancement of imaging modalities. The aim of this study is to assess the role of echocardiographic RV outflow tract (RVOT) function in the form of RVOT fractional shortening (RVOT FS) and RVOT systolic excursion (RVOT SE) for the assessment of RV function.
We studied ninety individuals divided equally into two groups. The control group included 45 normal healthy individuals and age-matched patient group included 45 patients with RV dysfunction which was defined by tricuspid annular plane systolic excursion (TAPSE) <16 mm and RV fractional area change (RV FAC) ≤35%. Echocardiography was performed to measure RVOT FS and RVOT SE and correlate them with other parameters of RV function including TAPSE, RV FAC, peak systolic velocity of the lateral tricuspid annulus (S') using pulsed tissue Doppler, and pulmonary acceleration time (PAcT).
RVOT FS showed positive correlation with TAPSE ( = 0.75, = 0.02), RV FAC ( = 0.45, = 0.003), and PAcT ( = 0.39, = 0.00) and negative correlation with left atrial dimensions (LADs) ( = -0.359, = 0.017) and left ventricular end-diastolic dimensions ( = -0.304, = 0.042). RVOT FS <32% was 93% sensitive and 98% specific to identify patients with impaired RV function. However, RVOT SE showed weak correlation with echocardiographic RV parameters. RVOT SE <5 mm was 80% sensitive and 76% specific to identify patients with impaired RV function.
RVOT FS is a simple valuable parameter that can be used for the assessment of RV function. However, RVOT SE is less accurate than RVOT FS in RV function assessment.
尽管成像技术迅速发展，但超声心动图评估右心室（RV）功能仍很困难，仍是一个灰色地带。本研究的目的是评估以右心室流出道（RVOT）分数缩短率（RVOT FS）和RVOT收缩期偏移（RVOT SE）形式的超声心动图RVOT功能在评估RV功能中的作用。
我们研究了90名个体，平均分为两组。对照组包括45名正常健康个体，年龄匹配的患者组包括45名RV功能障碍患者，其定义为三尖瓣环平面收缩期偏移（TAPSE）<16 mm和RV分数面积变化（RV FAC）≤35%。进行超声心动图检查以测量RVOT FS和RVOT SE，并将它们与RV功能的其他参数相关联，包括TAPSE、RV FAC、使用脉冲组织多普勒的三尖瓣环外侧峰值收缩速度（S'）和肺动脉加速时间（PAcT）。
RVOT FS与TAPSE（r = 0.75，P = 0.02）、RV FAC（r = 0.45，P = 0.003）和PAcT（r = 0.39，P = 0.00）呈正相关，与左心房大小（LADs）（r = -0.359，P = 0.017）和左心室舒张末期大小（r = -0.304，P = 0.042）呈负相关。RVOT FS<32%识别RV功能受损患者的敏感性为93%，特异性为98%。然而，RVOT SE与超声心动图RV参数的相关性较弱。RVOT SE<5 mm识别RV功能受损患者的敏感性为80%，特异性为76%。
RVOT FS是一个简单而有价值的参数，可用于评估RV功能。然而，在RV功能评估中，RVOT SE的准确性低于RVOT FS。
