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射血分数保留、降低和中等范围的心力衰竭患者右心室收缩功能评估

Assessment of right ventricular systolic function in heart failure with preserved, reduced and mid-range ejection fraction.

作者信息

Mostafa Shaimaa

机构信息

Benha University, Faculty of Medicine, Cardiovascular Department, 13511, Benha, Egypt.

出版信息

Indian Heart J. 2019 Sep-Oct;71(5):406-411. doi: 10.1016/j.ihj.2019.11.252. Epub 2019 Nov 20.

DOI:10.1016/j.ihj.2019.11.252
PMID:32035524
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7013188/
Abstract

BACKGROUND

Few studies have evaluated the right ventricle systolic function in different categories of heart failure despite its effect on outcomes.

METHODS AND RESULTS

Single-centre, cross-sectional study included 150 patients, 50 patients in each category of HF: group I, preserved; group II, mid-range; group III, reduced ejection fraction. Left ventricular systolic function was assessed by 3D echo, and right ventricular systolic function was assessed by fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler image (TDI), and global longitudinal strain (GLS). There was no significant difference among the three groups regarding sex, the prevalence of risk factors, but patients in group III were significantly older (p < 0.001) and had a higher prevalence of coronary artery disease (p = 0.004) than were found in the other two groups. In group I, the prevalence of RV systolic dysfunction was 18%, 22%, 14% and 26% by TAPSE, FAC, S wave velocity, and GLS, respectively. Their prevalence was higher in group II and much higher in group III than in group I. There were significant positive correlations among TAPSE, S wave velocity, GLS, and ejection fraction in groups II and III (p < 0.001).

CONCLUSION

The prevalence and severity of RV systolic dysfunction were positively correlated with LV systolic dysfunction, and the degree of RV dysfunction in mid-range was closer to reduce than preserved ejection fraction. STUDY REGISTRATION AT CLINICAL TRIAL.GOV: NCT03641599.

摘要

背景

尽管右心室收缩功能对预后有影响,但很少有研究评估不同类型心力衰竭患者的右心室收缩功能。

方法与结果

一项单中心横断面研究纳入了150例患者,分为三组,每组50例:I组,射血分数保留的心衰;II组,射血分数中间范围的心衰;III组,射血分数降低的心衰。通过三维超声心动图评估左心室收缩功能,通过面积变化分数(FAC)、三尖瓣环平面收缩期位移(TAPSE)、组织多普勒成像(TDI)和整体纵向应变(GLS)评估右心室收缩功能。三组在性别、危险因素患病率方面无显著差异,但III组患者年龄显著更大(p < 0.001),且冠心病患病率高于其他两组(p = 0.004)。在I组中,通过TAPSE、FAC、S波速度和GLS评估的右心室收缩功能障碍患病率分别为18%、22%、14%和26%。II组和III组的患病率高于I组,且III组更高。II组和III组中,TAPSE、S波速度、GLS与射血分数之间存在显著正相关(p < 0.001)。

结论

右心室收缩功能障碍的患病率和严重程度与左心室收缩功能障碍呈正相关,射血分数中间范围的心衰患者右心室功能障碍程度更接近射血分数降低的心衰,而非射血分数保留的心衰。在ClinicalTrials.gov上的研究注册编号:NCT03641599。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/6380e4efe072/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/45f658d8d29a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/77f9e7aac001/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/6380e4efe072/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/45f658d8d29a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/77f9e7aac001/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d174/7013188/6380e4efe072/gr3.jpg

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