Pediatric Cardiology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B100, Aurora, CO, USA.
Biostatistics Core, Research Institute of Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO.
Eur Heart J Cardiovasc Imaging. 2018 Sep 1;19(9):1026-1033. doi: 10.1093/ehjci/jex205.
To evaluate right ventricular functional indices using 3D echocardiography (3DE) between normal children and paediatric pulmonary hypertension (PH) patients, and to evaluate these indices as outcome predictors in children with PH.
Ninety-six paediatric PH patients from 2014 to 2016 were compared with 40 normal controls. All patients underwent 3DE and off-line analysis generated 3D end-diastolic volume, 3D end-systolic volume, 3D stroke volume, 3D right ventricular (RV) ejection fraction (EF), RV longitudinal strain (LS) free wall and septum, tricuspid annular plane systolic excursion (TAPSE), and fractional area change (FAC). PH patients had higher RV volumes, lower RV EF, lower free wall and septal RVLS, lower TAPSE, and lower FAC compared with normal controls (all P < 0.001). 3D RV EF, free wall RVLS, and FAC are predictors of adverse clinical outcomes [hazard ratio (confidence interval) 0.1 (0.03-0.27], P < 0.001; 0.17 (0.07-0.45), P < 0.001; 0.08 (0.03-0.22); P < 0.001, respectively).
Paediatric PH patients have impaired RV function compared with normal children. 3D RV EF, volumes, FAC, and free wall RV strain serve as outcome predictors for paediatric PH patients.
使用三维超声心动图（3DE）评估正常儿童和小儿肺动脉高压（PH）患者的右心室功能指标，并评估这些指标作为 PH 患儿的预后预测因子。
将 2014 年至 2016 年的 96 例小儿 PH 患者与 40 例正常对照进行比较。所有患者均行 3DE 检查，并进行离线分析得出 3D 舒张末期容积、3D 收缩末期容积、3D 每搏输出量、3D 右心室（RV）射血分数（EF）、RV 纵向应变（LS）游离壁和间隔、三尖瓣环平面收缩期位移（TAPSE）和分数面积变化（FAC）。PH 患者的 RV 容积较高，RV EF 较低，游离壁和间隔 RVLS 较低，TAPSE 和 FAC 较低，与正常对照组相比（均 P<0.001）。3D RV EF、游离壁 RVLS 和 FAC 是不良临床结局的预测因子[风险比（置信区间）0.1（0.03-0.27），P<0.001；0.17（0.07-0.45），P<0.001；0.08（0.03-0.22），P<0.001]。
与正常儿童相比，小儿 PH 患者的 RV 功能受损。3D RV EF、容积、FAC 和游离壁 RV 应变可作为小儿 PH 患者的预后预测因子。
