Hamilton-Craig Christian R, Stedman Kathy, Maxwell Ryan, Anderson Bonita, Stanton Tony, Chan Jonathan, Yamada Akira, Scalia Gregory M, Burstow Darryl J
Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.
University of Queensland, Brisbane, Australia.
Int J Cardiol Heart Vasc. 2016 Jun 23;12:38-44. doi: 10.1016/j.ijcha.2016.05.007. eCollection 2016 Sep.
Many echocardiographic parameters have been proposed to evaluate right ventricular (RV) systolic function. We comprehensively assessed a wide range of quantitative echocardiographic parameters in a single cohort compared with same-day cardiovascular magnetic resonance (CMR).
92 subjects were examined prospectively: Group 1 consisted of 46 healthy controls (21 males, 33.4 ± 11.4 years), Group 2 consisted of 46 patients (20 males, 38.5 ± 18.9 years) undergoing RV functional assessment by CMR (1.5 T). Echocardiography was performed on the same day as CMR; fractional area change (RVFAC), myocardial performance index via spectral Doppler (RVMPI), RVMPI via Doppler tissue imaging (RVMPI-DTI), peak systolic myocardial velocity by DTI (RVSm), tricuspid annular plane systolic excursion (TAPSE), speckle tracking strain, and three dimensional right ventricular ejection fraction (3DE-RV). Linear regression, Bland-Altman and receiver-operator-characteristic (ROC) analyses were performed. At ROC analysis, the most predictive echocardiographic methods were; RVFAC (AUC = 0.892), RVMPI (AUC 0.785), TAPSE (AUC 0.849) and 3DE-RV (AUC 0.909). 3DE-RV appeared the most accurate compared to CMR, although underestimated true RV volumes.
As compared to CMR; 3DE-RV, RVFAC, TAPSE and RVMPI were the most reliable predictors of RV function. These parameters can be recommended for clinical use.
已提出许多超声心动图参数来评估右心室(RV)收缩功能。我们在同一队列中全面评估了一系列定量超声心动图参数,并与同日进行的心血管磁共振成像(CMR)结果进行比较。
前瞻性检查了92名受试者:第1组由46名健康对照者组成(21名男性,年龄33.4±11.4岁),第2组由46名患者组成(20名男性,年龄38.5±18.9岁),这些患者接受了CMR(1.5T)的RV功能评估。超声心动图检查与CMR在同一天进行;测量了面积变化分数(RVFAC)、通过频谱多普勒测得的心肌性能指数(RVMPI)、通过组织多普勒成像测得的RVMPI(RVMPI-DTI)、通过DTI测得的收缩期心肌峰值速度(RVSm)、三尖瓣环平面收缩期位移(TAPSE)、斑点追踪应变以及三维右心室射血分数(3DE-RV)。进行了线性回归、Bland-Altman分析和受试者操作特征(ROC)分析。在ROC分析中,最具预测性的超声心动图方法为:RVFAC(曲线下面积[AUC]=0.892)、RVMPI(AUC 0.785)、TAPSE(AUC 0.849)和3DE-RV(AUC 0.909)。与CMR相比,3DE-RV似乎最为准确,尽管低估了真实的RV容积。
与CMR相比,3DE-RV、RVFAC、TAPSE和RVMPI是RV功能最可靠的预测指标。这些参数可推荐用于临床。