通过超声心动图评估轻度右心室压力超负荷犬模型中的右心室功能变化。
Changes in right ventricular function assessed by echocardiography in dog models of mild RV pressure overload.
作者信息
Morita Tomoya, Nakamura Kensuke, Osuga Tatsuyuki, Yokoyama Nozomu, Morishita Keitaro, Sasaki Noboru, Ohta Hiroshi, Takiguchi Mitsuyoshi
机构信息
Department of Veterinary Clinical Sciences, Laboratory of Veterinary Internal Medicine, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
出版信息
Echocardiography. 2017 Jul;34(7):1040-1049. doi: 10.1111/echo.13560. Epub 2017 May 11.
BACKGROUND
The assessment of hemodynamic change by echocardiography is clinically useful in patients with pulmonary hypertension. Recently, mild elevation of the mean pulmonary arterial pressure (PAP) has been shown to be associated with increased mortality. However, changes in the echocardiographic indices of right ventricular (RV) function are still unknown. The objective of this study was to validate the relationship between echocardiographic indices of RV function and right heart catheterization variables under a mild RV pressure overload condition.
METHODS AND RESULTS
Echocardiography and right heart catheterization were performed in dog models of mild RV pressure overload induced by thromboxane A analog (U46619) (n=7). The mean PAP was mildly increased (19.3±1.1 mm Hg), and the cardiac index was decreased. Most echocardiographic indices of RV function were significantly impaired even under a mild RV pressure overload condition. Multivariate analysis revealed that the RV free wall longitudinal strain (RVLS), standard deviation of the time-to-peak longitudinal strain of RV six segments (RV-SD) by speckle-tracking echocardiography, and Tei index were independent echocardiographic predictors of the mean PAP (free wall RVLS, β=-0.60, P<.001; RV-SD, β=0.40, P=.011), pulmonary vascular resistance (free wall RVLS, β=-0.39, P=.020; RV-SD, β=0.47, P=.0086; Tei index, β=0.34, P=.047), and cardiac index (Tei index, β=-0.65, P<.001).
CONCLUSIONS
Free wall RVLS, RV-SD, and Tei index are useful for assessing the hemodynamic change under a mild RV pressure overload condition.
背景
通过超声心动图评估血流动力学变化在肺动脉高压患者的临床治疗中具有重要意义。最近研究表明，平均肺动脉压（PAP）轻度升高与死亡率增加相关。然而，右心室（RV）功能的超声心动图指标变化尚不清楚。本研究的目的是验证在轻度右心室压力超负荷情况下，右心室功能的超声心动图指标与右心导管检查变量之间的关系。
方法与结果
对由血栓素A类似物（U46619）诱导的轻度右心室压力超负荷犬模型（n = 7）进行超声心动图和右心导管检查。平均PAP轻度升高（19.3±1.1 mmHg），心指数降低。即使在轻度右心室压力超负荷情况下，大多数右心室功能的超声心动图指标也显著受损。多变量分析显示，右心室游离壁纵向应变（RVLS）、斑点追踪超声心动图测量的右心室六个节段纵向应变达峰时间的标准差（RV-SD）和Tei指数是平均PAP（游离壁RVLS，β=-0.60，P<.001；RV-SD，β=0.40，P=.011）、肺血管阻力（游离壁RVLS，β=-0.39，P=.020；RV-SD，β=0.47，P=.0086；Tei指数，β=0.34，P=.047）和心指数（Tei指数，β=-0.65，P<.001）的独立超声心动图预测指标。
结论
游离壁RVLS、RV-SD和Tei指数有助于评估轻度右心室压力超负荷情况下的血流动力学变化。
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