Role of radial strain and displacement Imaging to quantify wall motion dyssynchrony in patients with left ventricular mechanical dyssynchrony and chronic right ventricular pressure overload
Role of radial strain and displacement Imaging to quantify wall motion dyssynchrony in patients with left ventricular mechanical dyssynchrony and chronic right ventricular pressure overload
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DOI：
10.1016/j.amjcard.2007.11.077
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发表时间：
2008-04-15
影响因子：
2.8
通讯作者：
Ito, Masaaki
中科院分区：
文献类型：
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作者：
Dohi, Kaoru;Onishi, Katsuya;Ito, Masaaki
左心室（LV）变形伴室间隔移位是慢性右心室（RV）压力超负荷（PO）患者最独特的超声心动图观察结果之一。然而，人们对 RVPO 对 LV 性能和区域同步性的影响知之甚少。因此，我们的目标是使用一种新颖的斑点跟踪方法来量化和表征局部左心室壁运动不同步性，以检验慢性 RVPO 影响局部心室壁运动、同步性和整体左心室功能的假设。对 20 名因肺动脉高压或肺动脉狭窄而患有 RVPO 的患者（平均年龄 53 +/- 16 岁，纽约心脏协会分级 2.6 +/- 0.7，峰值 RV 收缩压 73 +/- 28 mm Hg）和 20 名年龄匹配的正常受试者（平均年龄 47 +/- 16 岁）进行了位移和应变成像超声心动图研究。如果来自中左心室短轴周围的 6 个节段的节段信号的变化与每个时间帧的整体左心室信号的变化相反，则将其定义为不同步，并且总体左心室不同步计算为从 QRS 开始到等容舒张结束的指定时间间隔内所有 6 个节段的不同步百分比。 RVPO 与位移成像观察到的反常室间隔运动的很大程度的区域不同步相关（21 +/- 6%，p
Left ventricular (LV) deformation with ventricular septal shift is one of the most distinctive echocardiographic observations in patients with chronic right ventricular (RV) pressure overload (PO). However, little is known about the effects of RVPO on LV performance and regional synchrony. Accordingly, our objective was to test the hypothesis that chronic RVPO affects regional wall motion, synchronicity, and global LV function using a novel speckle-tracking approach to quantify and characterize regional LV wall motion dyssynchrony. Displacement and strain imaging echocardiographic studies were performed in 20 patients with RVPO from pulmonary arterial hypertension or pulmonic stenosis (mean age 53 +/- 16 years, New York Heart Association class 2.6 +/- 0.7, and peak RV systolic pressure 73 +/- 28 mm Hg) and 20 age-matched normal subjects (mean age 47 +/- 16 years). Segmental signals from 6 segments around the mid-LV short axis were defined as dyssynchronous if their changes were opposite to that of the global LV signal at each time frame, and overall LV dyssynchrony was calculated as the percentage of dyssynchrony in all 6 segments within the specified time interval from onset of QRS to the end of isovolumic relaxation. RVPO was associated with a large degree of regional dyssynchrony with paradoxical ventricular septal motion observed by displacement imaging (21 +/- 6%, p