Li Hui, Ye Teng, Su Lan, Wang Jue, Jia Zhijun, Wu Qilong, Liao Shusheng
Department of Ultrasound, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China.
Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China.
Rev Cardiovasc Med. 2023 Dec 25;24(12):366. doi: 10.31083/j.rcm2412366. eCollection 2023 Dec.
Right ventricle-pulmonary arterial (RV-PA) coupling is considered the gold standard for assessing right ventricular (RV) function and can be evaluated noninvasively by echocardiography. The ratios of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP), RV global longitudinal strain (G-RVLS)/PASP, and stroke volume/end-systolic volume (SV/ESV) have been proposed as surrogates of RV-PA coupling. The relationship of these parameters remains incompletely understood in patients with volume and pressure loading conditions. We aimed to compare these parameters and evaluate their relationship with 3D RV data in patients with RV pressure and volume overload.
This study was performed on 110 individuals who underwent 2D and 3D echocardiography. Fifty-four patients had RV volume overload (atrial septal defect (ASD) group), 34 patients had RV pressure overload (pulmonary hypertension (PH) group), and 22 were controls. TAPSE/PASP, G-RVLS/PASP and SV/ESV ratios were calculated. Correlations between parameters of RV-PA coupling and 3D data were assessed using general linear mixed models.
Compared with the ASD group, the PH group had lower TAPSE/PASP and G-RVLS/PASP ratios. The SV/ESV ratio had a strong correlation with right ventricle ejection fraction (RVEF) in both ASD and PH patients (r = 0.8703, 0.001 and r = 0.9388, 0.001, respectively). The G-RVLS/PASP ratio showed a strong or moderately negative relationship with end-diastolic volume (EDV), ESV and SV (r = -0.7768, 0.001; r = -0.7327, 0.0005 and r = -0.6816, 0.0018, respectively) in PH patients. The TAPSE/PASP ratio showed moderately negative correlations with EDV and ESV (r = -0.5712, 0.0012 and r = -0.5594, 0.0016, respectively) in PH patients.
Non-invasive RV-PA coupling parameters derived from echocardiography appear similar, but not identical to profiles in pressure-overloaded and volume-overloaded patients. The correlations between non-invasive RV-PA coupling parameters and 3D data displayed various degrees of correlation.
右心室-肺动脉（RV-PA）耦合被认为是评估右心室（RV）功能的金标准，并且可以通过超声心动图进行无创评估。三尖瓣环平面收缩期位移/肺动脉收缩压（TAPSE/PASP）、右心室整体纵向应变（G-RVLS）/PASP以及每搏输出量/收缩末期容积（SV/ESV）的比值已被提议作为RV-PA耦合的替代指标。在容量和压力负荷情况下，这些参数之间的关系仍未完全明确。我们旨在比较这些参数，并评估它们与右心室压力和容量超负荷患者的三维右心室数据之间的关系。
本研究对110例接受二维和三维超声心动图检查的个体进行。54例患者存在右心室容量超负荷（房间隔缺损（ASD）组），34例患者存在右心室压力超负荷（肺动脉高压（PH）组），22例为对照组。计算TAPSE/PASP、G-RVLS/PASP和SV/ESV比值。使用一般线性混合模型评估RV-PA耦合参数与三维数据之间的相关性。
与ASD组相比，PH组的TAPSE/PASP和G-RVLS/PASP比值较低。在ASD和PH患者中，SV/ESV比值与右心室射血分数（RVEF）均呈强相关性（分别为r = 0.8703，P < 0.001和r = 0.9388，P < 0.001）。在PH患者中，G-RVLS/PASP比值与舒张末期容积（EDV）、收缩末期容积（ESV）和每搏输出量（SV）呈强或中度负相关（分别为r = -0.7768，P < 0.001；r = -0.7327，P < 0.0005和r = -0.6816，P < 0.
