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二维超声心动图和应变成像评价 RCA CTO 再通患者的右心房功能。

Evaluation of right atrial function by two-dimensional echocardiography and strain imaging in patients with RCA CTO recanalization.

机构信息

University Medical Center Mainz - Center of Cardiology, Johannes Gutenberg University, Mainz, Germany.

Department of Cardiology, University Medical Center Mainz, Langenbeckstr.1, 55131, Mainz, Germany.

出版信息

BMC Cardiovasc Disord. 2023 Feb 12;23(1):85. doi: 10.1186/s12872-023-03108-y.

DOI:10.1186/s12872-023-03108-y
PMID:36774496
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9922456/
Abstract

OBJECTIVES

The right heart is mainly supplied with blood by the right coronary artery (RCA). The impact of RCA chronic total occlusion (CTO) on the function of the right heart [right atrium (RA) and ventricle (RV)] and whether successful recanalization of a RCA CTO improves the function of the right heart is not clearly understood yet. We aimed to evaluate right atrial function after recanalization of the RCA using transthoracic echocardiography with additional strain imaging.

METHODS AND RESULTS

Fifty-five patients undergoing RCA CTO recanalization at the University Medical Center of Mainz were included in the study. Right atrial strain was assessed before and 6 months after successful CTO revascularization. The median age of the total collective was 66 (50-90) years. We did not find difference in our analysis of RA Volume (p 0.086), RA area (p 0.093), RA major dimension (p 0.32) and RA minor dimension (p 0.139) at baseline and follow-up. Mean RA reservoir strain at baseline was 30.9% (21.1-43.0) vs. 33.4% (20.7-47.7) at follow up (p < 0.001). Mean RA conduit strain was - 17.5% (- 10.7-(- 29.7)) at baseline vs. - 18.2% (- 9.6-(- 31.7)) at follow-up (p = 0.346). Mean RA contraction strain was - 12.9% (- 8.0- (- 21.3)) at baseline vs. - 15.5% (- 8.7-(- 26.6)) at follow-up (p < 0.001).

CONCLUSION

Right atrial function was altered in patients with RCA CTO. Successful revascularisation of an RCA CTO improved RA function assessed by strain imaging at follow-up.

摘要

目的

右心主要由右冠状动脉（RCA）供血。RCA 慢性完全闭塞（CTO）对右心功能[右心房（RA）和右心室（RV）]的影响，以及 RCA CTO 成功再通是否改善右心功能尚不清楚。我们旨在使用经胸超声心动图联合应变成像评估 RCA 再通后右心房功能。

方法和结果

本研究纳入了在美因茨大学医学中心接受 RCA CTO 再通的 55 例患者。在成功 CTO 血运重建前和 6 个月后评估右心房应变。总人群的中位年龄为 66（50-90）岁。在基线和随访时，我们在 RA 容积（p 0.086）、RA 面积（p 0.093）、RA 大尺寸（p 0.32）和 RA 小尺寸（p 0.139）方面的分析中未发现差异。基线时平均 RA 储备应变率为 30.9%（21.1-43.0），随访时为 33.4%（20.7-47.7）（p<0.001）。基线时平均 RA 传导应变率为-17.5%（-10.7-（-29.7）），随访时为-18.2%（-9.6-（-31.7））（p=0.346）。基线时平均 RA 收缩应变率为-12.9%（-8.0-（-21.3）），随访时为-15.5%（-8.7-（-26.6））（p<0.001）。

结论

RCA CTO 患者右心房功能发生改变。RCA CTO 成功再通可改善随访时的 RA 功能，应变成像评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/c1d8b607960d/12872_2023_3108_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/2afb6fc3748b/12872_2023_3108_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/ee4b4f330f64/12872_2023_3108_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/0f8901b10546/12872_2023_3108_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/d2862d8455a9/12872_2023_3108_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/76471aed58dd/12872_2023_3108_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/c1d8b607960d/12872_2023_3108_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/2afb6fc3748b/12872_2023_3108_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/64ab464f2605/12872_2023_3108_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/49f1698ef507/12872_2023_3108_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/ee4b4f330f64/12872_2023_3108_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/0f8901b10546/12872_2023_3108_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/d2862d8455a9/12872_2023_3108_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/76471aed58dd/12872_2023_3108_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5d/9922456/c1d8b607960d/12872_2023_3108_Fig8_HTML.jpg

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本文引用的文献

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BMC Cardiovasc Disord. 2022 Mar 14;22(1):102. doi: 10.1186/s12872-022-02546-4.
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Right atrium size in the general population.普通人群的右心房大小。
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Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease.
多模态评估及左心房功能作为心血管疾病影像学标志物的作用。
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Prognostic Utility of Echocardiographic Atrial and Ventricular Strain Imaging in Patients With Cardiac Amyloidosis.超声心动图心房和心室应变成像在心脏淀粉样变性患者中的预后价值。
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Current clinical applications of speckle tracking echocardiography for assessment of left atrial function.斑点追踪超声心动图在评估左心房功能中的临床应用。
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