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三尖瓣手术后右心室功能超声心动图参数的变化。

Behavior of echocardiographic parameters of right ventricular function after tricuspid surgery.

机构信息

University of Granada, Calle Fuente de Lima, N 27, 2 A, 28024, Madrid, Granada, Spain.

Hospital Universitario Virgen de Las Nieves, Avenida de Las Fuerzas Armadas, 2, 18014, Granada, Spain.

出版信息

Sci Rep. 2022 Nov 14;12(1):19447. doi: 10.1038/s41598-022-24048-1.

Abstract

Evaluation of right ventricular (RV) function after tricuspid valve surgery is complex. The objective was to identify the most appropriate RV function parameters for this purpose. This prospective study included 70 patients undergoing cardiac and tricuspid valve (TV) surgery. RV size and function parameters were determined at 3 months and 1-year post-surgery. Categorical variables were analyzed with the McNemar test and numerical variables with the Student's t-test for related samples or, when non-normally distributed, the Wilcoxon test. Spearman's rho was used to determine correlations between variables at 3 months and 1 year. RV diameters were reduced at 3 months post-surgery and were then unchanged at 1 year. Tricuspid annular plane systolic excursion (TAPSE) and S' wave values were worse at 3 months and then improved at 1 year (t-score-2.35, p 0.023; t-score-2.68; p 0.010). There was no significant reduction in free wall longitudinal strain (LS) or shortening fraction (SF) at 3 months (t-score 1.421 and - 1.251; p 0.218 and 0.172), and they were only slightly below pre-surgical values at 1 year. No relationship was found between RV function parameters and mortality or major complications. During the first few months after TV surgery, LS may be a more appropriate parameter to evaluate global ventricular function in comparison to TAPSE. At 1 year, good correlations are observed between TAPSE, S' wave, and LS values.

摘要

三尖瓣手术后右心室(RV)功能的评估较为复杂。本研究旨在确定最适合的 RV 功能参数。前瞻性纳入 70 例行心脏和三尖瓣(TV)手术的患者。术后 3 个月和 1 年时,评估 RV 大小和功能参数。采用 McNemar 检验分析分类变量,采用学生 t 检验分析相关样本的数值变量,或在非正态分布时采用 Wilcoxon 检验。采用 Spearman 相关分析评估 3 个月和 1 年时变量之间的相关性。术后 3 个月 RV 直径减小,1 年后无明显变化。三尖瓣环平面收缩期位移(TAPSE)和 S'波值在术后 3 个月时较差,1 年后改善(t 评分-2.35,p 0.023;t 评分-2.68;p 0.010)。术后 3 个月游离壁纵向应变(LS)和缩短分数(SF)无明显降低(t 评分 1.421 和-1.251;p 0.218 和 0.172),1 年后略低于术前值。RV 功能参数与死亡率或主要并发症之间无显著相关性。TV 手术后的最初几个月,LS 可能比 TAPSE 更适合评估整体心室功能。1 年后,TAPSE、S'波和 LS 值之间存在良好的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a290/9663697/11da7c02ccb9/41598_2022_24048_Fig1_HTML.jpg

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