Echocardiography in the Risk Assessment of Acute Pulmonary Embolism.
Echocardiography in the Risk Assessment of Acute Pulmonary Embolism.
复制标题
超声心动图在急性肺栓塞风险评估中的应用。
DOI：
10.1055/s-0036-1597563
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发表时间：
2017
影响因子：
3.2
通讯作者：
Rajagopal,Sudarshan
中科院分区：
文献类型：
--
作者：
Dahhan,Talal;Alenezi,Fawaz;Samad,Zainab;Rajagopal,Sudarshan
急性肺栓塞（PE）是发病率和死亡率的主要原因，根据患者的血流动力学状态和临床特征分为大面积（高风险）、次大面积（中等风险）或非大面积（低风险）。目前，亚大块PE患者的管理仍存在争议，改善风险评估的方法至关重要。在这篇综述中，我们讨论了几种超声心动图方法来评估右心功能，可能有助于急性PE患者的风险评估。其范围从右心室（RV）功能的定性评估（如主观RV功能和McConnell征）到最近开发的RV功能定量参数（如三尖瓣环平面收缩期偏移、RV/左心室比率以及RV整体和游离壁纵向应变）。由于其可重复性和客观性，定量RV超声心动图评估在急性PE评估中越来越重要。目前使用超声心动图进行急性PE风险评估的局限性是缺乏RV参数的标准值，不同超声平台之间缺乏测量标准化，以及超声心动图检查和报告在各中心之间的异质性。
Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At this time, the management of patients with submassive PE remains controversial and approaches for improving risk assessment are critical. In this review, we discuss several echocardiographic methods to assess right heart function that may aid in the risk assessment of patients with acute PE. They range from qualitative assessments of right ventricular (RV) function, such as subjective RV function and McConnell sign, to more recently developed quantitative parameters of RV function, such as tricuspid annular plane systolic excursion, RV/left ventricular ratio, and RV global and free wall longitudinal strain. Because of their reproducibility and objective nature, quantitative RV echocardiographic assessments have been gaining importance in the assessment of acute PE. Current limitations to the use of echocardiography for risk assessment in acute PE are the lack of normative values for RV parameters, the absence of standardization of measurements across different ultrasound platforms, and the heterogeneity of the performance of echocardiographic examinations and reports across centers.