Al-Biltagi Mohammed, Elrazaky Osama, Mawlana Wegdan, Srour Esraa, Shabana Ahmed Hamdy
Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt.
World J Clin Pediatr. 2022 Jan 9;11(1):71-84. doi: 10.5409/wjcp.v11.i1.71.
Right ventricular (RV) function is frequently overlooked during dilated cardiomyopathy (DCM) evaluation.
To evaluate RV function in children with idiopathic DCM using relatively recent echocardiographic modalities.
We prospectively studied the cardiac function in 50 children with idiopathic DCM and 50 healthy children as a control group, using four-dimensional echocardiography (4-DE), Tissue Doppler Imaging (TDI), and two-dimensional-speckles tracking echocardiography (2-D-STE). RV EF was measured by 4-DE.
The auto left (LV) ejection fractions (EF) measured by 2-D-STE were significantly lower in the patients' group than in the control. The sphericity index was also significantly lower in children with DCM than in the control. RV EF measured by 4-DE was significantly lower in the patient's group than the control. RV S wave, e´/a' ratio, myocardial performance index (MPI), and tricuspid annular plane systolic excursion (TAPSE) were significantly impaired in children with DCM than in control. Both LV and RV global longitudinal strains (GLS) were significantly reduced in children with DCM than in control. RVGLS was significantly associated with the duration since diagnosis, tricuspid annulus S wave, RV MPI, and TAPSE, but not with the age of the patients, RV EF, or e´/a' ratio.
There was impairment of the RV LGS and other systolic and diastolic parameters in children with DCM. STE and TDI can help to detect the early decline of RV function.
在扩张型心肌病(DCM)评估过程中,右心室(RV)功能常常被忽视。
使用相对较新的超声心动图方法评估特发性DCM患儿的右心室功能。
我们前瞻性地研究了50例特发性DCM患儿和50例健康儿童作为对照组的心脏功能,采用了四维超声心动图(4-DE)、组织多普勒成像(TDI)和二维斑点追踪超声心动图(2-D-STE)。通过4-DE测量右心室射血分数(RV EF)。
患者组通过2-D-STE测量的左心室(LV)自动射血分数(EF)显著低于对照组。DCM患儿的球形指数也显著低于对照组。患者组通过4-DE测量的RV EF显著低于对照组。DCM患儿的RV S波、e´/a'比值、心肌性能指数(MPI)和三尖瓣环平面收缩期位移(TAPSE)较对照组显著受损。DCM患儿的左心室和右心室整体纵向应变(GLS)均较对照组显著降低。RV GLS与诊断后的病程、三尖瓣环S波、RV MPI和TAPSE显著相关,但与患者年龄、RV EF或e´/a'比值无关。
DCM患儿存在右心室纵向应变及其他收缩和舒张参数的损害。STE和TDI有助于检测右心室功能的早期下降。