Sljivic Aleksandra, Kleut Milena Pavlovic, Celic Vera, Neskovic Aleksandar N, Nesic Ivan, Gazibara Tatjana
Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic-Dedinje", Belgrade, Serbia.
Department of Internal Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
J Cardiovasc Echogr. 2024 Apr-Jun;34(2):50-56. doi: 10.4103/jcecho.jcecho_13_24. Epub 2024 Jun 28.
Two-dimensional speckle tracking echocardiography (2D-STE) and three-dimensional echocardiography (3DE) may overcome many limitations of the conventional 2D echocardiography (2DE) in assessing right ventricular (RV) function. We sought to determine whether characteristics of the right atrium and right ventricle as measured by 2D-STE and 3DE are associated with cardiac mortality in patients with ischemic heart failure, over a 6-year follow-up.
The inclusion criteria were ischemic cardiomyopathy with left ventricular ejection fraction of <40% diagnosed using standard 2DE, 2D-STE, and 3DE examination. Patients were followed for 6 years, and cardiac mortality was recorded.
The study sample comprised a total of 54 participants. During the period of follow-up, 24% (13/54) died. The 2DE models showed that being older, having a higher body mass index (BMI), having higher systolic pulmonary artery pressure (SPAP), and a lower RV global longitudinal strain were associated with cardiac mortality in our cohort after 6-year follow-up. Finally, the 3DE models showed that in addition to being older, having higher BMI, having a higher SPAP baseline, lower baseline 3DE RV stroke volume, and larger 3DE RV end-diastolic volume and 3DE RV end-systolic volume were associated with cardiac mortality over 6-year follow-up.
This study provides evidence that RV dysfunction as seen on 2D-STE and 3DE could be associated with increased risk of cardiac-related mortality in patients with heart failure over 6 years.
二维斑点追踪超声心动图（2D-STE）和三维超声心动图（3DE）可能克服传统二维超声心动图（2DE）在评估右心室（RV）功能方面的许多局限性。我们试图确定在6年随访期间，通过2D-STE和3DE测量的右心房和右心室特征是否与缺血性心力衰竭患者的心脏死亡率相关。
纳入标准为使用标准2DE、2D-STE和3DE检查诊断为左心室射血分数<40%的缺血性心肌病患者。对患者进行6年随访，并记录心脏死亡率。
研究样本共包括54名参与者。在随访期间，24%（13/54）死亡。2DE模型显示，在我们的队列中，6年随访后，年龄较大、体重指数（BMI）较高、收缩期肺动脉压（SPAP）较高以及右心室整体纵向应变较低与心脏死亡率相关。最后，3DE模型显示，除了年龄较大、BMI较高、SPAP基线较高外，3DE右心室搏出量基线较低、3DE右心室舒张末期容积和3DE右心室收缩末期容积较大与6年随访期间的心脏死亡率相关。
本研究提供了证据，表明2D-STE和3DE显示的右心室功能障碍可能与心力衰竭患者6年内心脏相关死亡风险增加有关。
