From the Department of Cardiology.
Department of Radiology, Rigshospitalet, University of Copenhagen, Denmark.
ASAIO J. 2020 Jan;66(1):8-16. doi: 10.1097/MAT.0000000000000925.
Using four-dimensional (4D) cardiac computed tomography (CCT) scans at rest and immediately after exercise, we examined the right heart chamber sizes and systolic function and its association with exercise capacity in left ventricular assist device (LVAD) recipients. Fifteen patients with HeartMate (HM) II or 3 underwent echocardiography and maximal cardiopulmonary exercise test. Subsequently, contrast-enhanced CCT scans were performed at rest and immediately after two minutes of supine 25 Watt ergometer bike exercise. Patients were (60 ± 12 years of age) 377 ± 347 days postimplant. Peak oxygen uptake (pVO2) was 15 ± 5 ml/kg/min. LV ejection fraction measured by echocardiography was 15 ± 9%. Pump speed was 9500 ± 258 in HM II and 5518 ± 388 rpm in HM 3 recipients. Resting right atrial ejection fraction (RAEF) was 18 ± 9%, and right ventricular ejection fraction (RVEF) was 36 ± 8%. During stress, RAEF was 19 ± 10%, and RVEF was 37 ± 8%. RAEF and RVEF did not correlate significantly with pVO2 at rest or during stress. Resting-RAEF and stress RAEF correlated significantly: r = 0.87, p < 0.01 as did resting RVEF and stress RVEF: r = 0.76, p < 0.01. In conclusion, resting-EF predicted stress-EF for both RA and RV in patients with an LVAD. Neither RVEF nor RAEF correlated with pVO2.
使用静息和运动后即刻的四维（4D）心脏计算机断层扫描（CCT），我们检查了左心室辅助装置（LVAD）受者的右心腔大小和收缩功能及其与运动能力的关系。15 名 HeartMate（HM） II 或 3 型患者接受了超声心动图和最大心肺运动试验。随后，在静息状态下和仰卧位 25 瓦特健身车运动 2 分钟后立即进行对比增强 CCT 扫描。患者植入后（60±12）岁，植入后（377±347）天。峰值摄氧量（pVO2）为 15±5 ml/kg/min。超声心动图测量的左心室射血分数为 15±9%。HM II 组的泵转速为 9500±258 rpm，HM 3 组为 5518±388 rpm。静息右心房射血分数（RAEF）为 18±9%，右心室射血分数（RVEF）为 36±8%。在应激时，RAEF 为 19±10%，RVEF 为 37±8%。RAEF 和 RVEF 与静息或应激时的 pVO2 无显著相关性。静息 RAEF 和应激 RAEF 显著相关：r = 0.87，p < 0.01，静息 RVEF 和应激 RVEF 也显著相关：r = 0.76，p < 0.01。总之，LVAD 患者的静息 EF 预测了 RA 和 RV 的应激 EF。RVEF 和 RAEF 均与 pVO2 无相关性。
