Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
Physiol Rep. 2023 Jul;11(13):e15751. doi: 10.14814/phy2.15751.
Diastolic stiffness coefficient (β) and end-diastolic elastance (Eed) are ventricular-specific diastolic parameters. However, the diastolic function of right ventricle had not been investigated sufficiently due to the lack of established evaluation method. We evaluated the validity of these parameters calculated using only data of right heart catheterization (RHC) and assessed it in patients with restrictive cardiomyopathy (RCM) and cardiac amyloidosis. We retrospectively analyzed 46 patients with heart failure who underwent RHC within 10 days of cardiac magnetic resonance (CMR). Right ventricular end-diastolic volume and end-systolic volume were calculated using only RHC data, which were found to be finely correlated with those obtained from CMR. β and Eed calculated by this method were also significantly correlated with those derived from conventional method using CMR. By this method, β and Eed were significantly higher in RCM with amyloidosis group than dilated cardiomyopathy group. In addition, the β and Eed calculated by our method were finely correlated with E/A ratio on echocardiography. We established an easy method to estimate β and Eed of right ventricle from only RHC. The method finely demonstrated right ventricular diastolic dysfunction in patients with RCM and amyloidosis.
舒张僵硬系数（β）和舒张末期弹性（Eed）是心室特有的舒张参数。然而，由于缺乏既定的评估方法，右心室的舒张功能尚未得到充分研究。我们评估了仅使用右心导管检查（RHC）数据计算这些参数的有效性，并在限制型心肌病（RCM）和心脏淀粉样变性患者中进行了评估。我们回顾性分析了 46 例在心脏磁共振（CMR）检查后 10 天内接受 RHC 的心力衰竭患者。仅使用 RHC 数据计算右心室舒张末期容积和收缩末期容积，发现与 CMR 获得的值具有很好的相关性。用该方法计算的β和 Eed 与传统方法用 CMR 计算的β和 Eed 也显著相关。用该方法，RCM 伴淀粉样变性组的β和 Eed 明显高于扩张型心肌病组。此外，我们的方法计算的β和 Eed 与超声心动图上的 E/A 比值具有很好的相关性。我们建立了一种仅从 RHC 估算右心室β和 Eed 的简便方法。该方法可精细地显示 RCM 和淀粉样变性患者的右心室舒张功能障碍。
