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使用组织多普勒和斑点追踪超声心动图评估伊伐布雷定是否能改善右心室功能。

Using Tissue Doppler and Speckle Tracking Echocardiography to Assess if Ivabradine Improves Right Ventricular Function.

作者信息

Gul Murat, Inci Sinan, Aksan Gokhan, Sigirci Serhat, Keskin Pinar

机构信息

Cardiology, Aksaray University, Faculty of Medicine, Aksaray, TUR.

Cardiology, Aksaray University School of Medicine, Aksaray, TUR.

出版信息

Cureus. 2021 Jan 26;13(1):e12920. doi: 10.7759/cureus.12920.

Abstract

Objective To evaluate the mid-term effects of ivabradine on right ventricular functions in patients with heart failure. Methods A prospective study was conducted on 52 patients who had heart failure in normal sinus rhythm (59% male, age: 64.76 ±12.49 years). Right ventricular functions were measured at baseline, after one month and one year by conventional and tissue Doppler echocardiography imaging. The parameters, right ventricular (RV) longitudinal strain (LS), RV systolic longitudinal strain rate (LSRs), RV early diastolic longitudinal strain rate, and late diastolic longitudinal strain rate, were evaluated by apical four-chamber grayscale imaging through the free wall of RV in accordance with the automated function imaging protocol. Results During the follow-up, the pulmonary artery systolic pressure (PASP), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI), E peak, and A peak values were similar to the basal values. While comparing the basal values of the global longitudinal systolic strain (GLS), LS, LSRs, longitudinal strain rate diastolic early filling (LSRe), and longitudinal strain rate diastolic late filling (LSRa), there were no differences in the first month but a significant increase was observed on one-year follow-up (p<0.001). Conclusion At the one-year follow-up, the heart failure patients who were given ivabradine treatment showed an improvement in the right ventricular function assessed by the new echocardiographic techniques.

摘要

目的 评估伊伐布雷定对心力衰竭患者右心室功能的中期影响。方法 对52例正常窦性心律的心力衰竭患者进行前瞻性研究(男性占59%,年龄:64.76±12.49岁)。在基线、1个月和1年后,通过传统和组织多普勒超声心动图成像测量右心室功能。根据自动功能成像协议,通过右心室游离壁的心尖四腔灰度成像评估右心室(RV)纵向应变(LS)、RV收缩期纵向应变率(LSRs)、RV舒张早期纵向应变率和舒张晚期纵向应变率等参数。结果 在随访期间,肺动脉收缩压(PASP)、RV面积变化分数(RVFAC)、三尖瓣环平面收缩期位移(TAPSE)、心肌性能指数(MPI)、E峰和A峰值与基础值相似。比较整体纵向收缩应变(GLS)、LS、LSRs、舒张早期充盈纵向应变率(LSRe)和舒张晚期充盈纵向应变率(LSRa)的基础值,1个月时无差异,但在1年随访时观察到显著增加(p<0.001)。结论 在1年随访时,接受伊伐布雷定治疗的心力衰竭患者经新的超声心动图技术评估显示右心室功能有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f64/7907781/ee48eb57d804/cureus-0013-00000012920-i01.jpg

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