Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany.
Department of Computer Science, Wilhelm-Schickard-Institute, Eberhard-Karls-University Tübingen, Tübingen, Germany.
J Cardiothorac Vasc Anesth. 2019 Jun;33(6):1527-1532. doi: 10.1053/j.jvca.2019.02.011. Epub 2019 Feb 13.
In daily echocardiographic practice, the right ventricle (RV) is assessed using mostly 2-dimensional (2D) echocardiography. Parameters measuring longitudinal shortening (eg, tricuspid annular plane systolic excursion) or changes in areas (eg, fractional area change) are used as surrogates for right ventricular function. Three-dimensional (3D) echocardiography-based techniques allow for cardiac magnetic resonance imaging-validated assessment of the RV. Depiction of regional right ventricular function is of increasing clinical interest. This study aimed to calculate regional volumetric changes in the right ventricular inlet, apical section, and outflow tract. Correlations between traditional parameters and regional right ventricular function were studied.
Retrospective cohort study on patients scheduled for cardiac surgery.
Tertiary care university hospital.
The study comprised 80 patients scheduled for cardiac surgery.
Based on 3D echocardiographic datasets, mesh models of the RV were generated on a vendor-independent platform. The meshes were further cut into the following 3 regions: the inlet part, the apical section, and the outflow tract. The regional volumes and ejection fractions were compared with the global right ventricular and left ventricular functions. Regional volumes were correlated linearly with the global end-diastolic volume. The right ventricular outflow tract demonstrated a significantly lower ejection fraction than the inlet part (34% ± 11% v 28% ± 11%; p = 0.0054). The function in the right ventricular outflow tract was reduced significantly compared with the global right ventricular function in patients with severely reduced left ventricular ejection fraction (<20%).
The different parts of the RV seem to have different ejection fractions. Different regions of the RV are affected differently by reduced left ventricular ejection fraction. Regional right ventricular analyses could help clinicians better understand pathologic states of the RV.
在日常超声心动图实践中，右心室（RV）主要通过二维（2D）超声心动图进行评估。测量纵向缩短（例如，三尖瓣环平面收缩期位移）或面积变化（例如，面积分数变化）的参数用作右心室功能的替代指标。基于三维（3D）超声心动图的技术可对 RV 进行心脏磁共振成像验证评估。描绘局部 RV 功能的能力引起了越来越多的临床关注。本研究旨在计算 RV 入口、心尖段和流出道的局部容积变化。研究了传统参数与局部 RV 功能之间的相关性。
对计划接受心脏手术的患者进行回顾性队列研究。
三级保健大学医院。
该研究纳入了 80 名计划接受心脏手术的患者。
基于 3D 超声心动图数据集，在供应商独立的平台上生成 RV 的网格模型。将网格进一步切割成以下 3 个区域：入口部分、心尖段和流出道。将局部容积和射血分数与整体右心室和左心室功能进行比较。局部容积与整体舒张末期容积呈线性相关。右心室流出道的射血分数明显低于入口部分（34%±11%比 28%±11%；p=0.0054）。与严重左心室射血分数降低（<20%）的患者的整体右心室功能相比，右心室流出道的功能明显降低。
RV 的不同部位似乎具有不同的射血分数。不同的 RV 区域受左心室射血分数降低的影响不同。局部 RV 分析可以帮助临床医生更好地了解 RV 的病理状态。
