3D echocardiographic evaluation of right ventricular function and strain: a prognostic study in paediatric pulmonary hypertension
3D echocardiographic evaluation of right ventricular function and strain: a prognostic study in paediatric pulmonary hypertension
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DOI：
10.1093/ehjci/jex205
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发表时间：
2018-09-01
影响因子：
6.2
通讯作者：
Ivy, D. Dunbar
中科院分区：
文献类型：
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作者：
Jone, Pei-Ni;Schafer, Michal;Ivy, D. Dunbar
目的使用3D超声心动图（3DE）评价正常儿童和小儿肺动脉高压（PH）患者的右心室功能指数，并评价这些指标作为PH儿童结局的预测因素。方法和结果将2014年至2016年的96例小儿PH患者与40例正常对照进行比较。所有患者均接受3DE检查，并离线分析生成3D舒张末期容积、3D收缩末期容积、3D每搏输出量、3D右心室（RV）射血分数（EF）、RV游离壁和间隔纵向应变（LS）、三尖瓣环平面收缩期偏移（TAPSE）和面积变化分数（FAC）。PH组右室容积、右室射血分数、游离壁和间隔RVLS、TAPSE和FAC均显著低于正常对照组（P均<0.001）。3D RV EF、游离壁RVLS和FAC是不良临床结局的预测因子[风险比（置信区间）0.1（0.03-0.27），P <0.001; 0.17（0.07-0.45），P <0.001; 0.08结论PH患儿RV功能较正常儿童受损。3D RV EF、容积、FAC和游离壁RV应变可作为儿科PH患者的结局预测因子。
Aims To evaluate right ventricular functional indices using 3D echocardiography (3DE) between normal children and paediatric pulmonary hypertension (PH) patients, and to evaluate these indices as outcome predictors in children with PH.Methods and results Ninety-six paediatric PH patients from 2014 to 2016 were compared with 40 normal controls. All patients underwent 3DE and off-line analysis generated 3D end-diastolic volume, 3D end-systolic volume, 3D stroke volume, 3D right ventricular (RV) ejection fraction (EF), RV longitudinal strain (LS) free wall and septum, tricuspid annular plane systolic excursion (TAPSE), and fractional area change (FAC). PH patients had higher RV volumes, lower RV EF, lower free wall and septal RVLS, lower TAPSE, and lower FAC compared with normal controls (all P < 0.001). 3D RV EF, free wall RVLS, and FAC are predictors of adverse clinical outcomes [hazard ratio (confidence interval) 0.1 (0.03-0.27], P < 0.001; 0.17 (0.07-0.45), P < 0.001; 0.08 (0.03-0.22); P < 0.001, respectively).Conclusion Paediatric PH patients have impaired RV function compared with normal children. 3D RV EF, volumes, FAC, and free wall RV strain serve as outcome predictors for paediatric PH patients.