Fayssoil Abdallah, Boisson De Chazournes Pierre, Hauguel-Moreau Marie, Mansart Arnaud, Mansencal Nicolas
Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.
Université Paris-Saclay, UVSQ, Inserm, 2I, 78000 Versailles, Yvelines, France.
Eur Heart J Case Rep. 2024 Nov 28;8(12):ytae632. doi: 10.1093/ehjcr/ytae632. eCollection 2024 Dec.
Respiratory muscle function can be affected in patients with heart failure. Ultrasound can be used to assess diaphragm, the main inspiratory muscle. Speckle tracking imaging is an imaging technology providing the evaluation of tissue deformation during contraction. We aimed to evaluate the contribution of traditional echography and 2D speckle tracking imaging in the evaluation and monitoring of patients with acute heart failure (AHF).
We report a series of four cases of AHF. Diaphragm ultrasound coupled with diaphragm 2D speckle tracking imaging was performed at admission and after decongestive therapy, in cardiac intensive care unit. Patients, at admission, disclosed higher diaphragm 2D strain value and higher diaphragm inspiratory motion value in the context of higher cardiac loading that significantly decrease after decongestive therapy, except for one patient. Diaphragm motion remained less than 10 mm (weakness), despite medical therapy in Cases 2, 3, and 4. Among them, 3 months later, one patient (Case 3) experienced an episode of AHF.
Diaphragm ultrasound coupled with diaphragm 2D speckle tracking imaging is feasible and may be used to monitor respiratory status patients with AHF.
心力衰竭患者的呼吸肌功能可能会受到影响。超声可用于评估主要吸气肌膈肌。斑点追踪成像技术是一种可在组织收缩时评估其变形情况的成像技术。我们旨在评估传统超声心动图和二维斑点追踪成像在急性心力衰竭（AHF）患者评估和监测中的作用。
我们报告了4例AHF病例。在心脏重症监护病房，入院时和进行充血性心力衰竭治疗后均进行了膈肌超声检查及膈肌二维斑点追踪成像。患者入院时，在心脏负荷较高的情况下，膈肌二维应变值和膈肌吸气运动值较高，除1例患者外，充血性心力衰竭治疗后这些值显著降低。在病例2、3和4中，尽管进行了药物治疗，但膈肌运动仍小于10毫米（无力）。其中，3个月后，1例患者（病例3）发生了一次AHF发作。
膈肌超声检查及膈肌二维斑点追踪成像可行，可用于监测AHF患者的呼吸状态。
