Right Ventricular Inefficiency in Repaired Tetralogy of Fallot: Proof of Concept for Energy Calculations From Cardiac MRI Data
Right Ventricular Inefficiency in Repaired Tetralogy of Fallot: Proof of Concept for Energy Calculations From Cardiac MRI Data
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DOI：
10.1007/s10439-010-0107-2
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发表时间：
2010-12-01
影响因子：
3.8
通讯作者：
Gottliebson, William M.
中科院分区：
文献类型：
--
作者：
Das, Ashish;Banerjee, Rupak K.;Gottliebson, William M.
法洛四联症修复术(RTOF)患者右室(RV)扩张和功能障碍。为了防止它们的死亡，肺动脉瓣置换术是必要的，尽管缺乏可靠的诊断参数对合适的时机提出了挑战。在这项先导性研究中，我们假设每搏功(Sw)和能量计算将描绘rTOF中RV性能的低效。利用在心导管插入术和MRI研究中获得的右室压力和容量测量，计算rTOF和正常受试者的右室Sw。计算主肺动脉的能量转移率和能量转移率。与正常RV相比，rTOF RV具有更高的工作压力、更低的计算Sw(0.078 J比0.115 J)和更高的PA负能量传递(0.044 J比0.002 J)。此外，正常RV的能量传递比(1.06)是rTOF RV(0.56)的近两倍。RV Sw和能量转移率描述了rTOF和正常受试者之间从RV到PA的血流的重要操作效率差异。我们的试验数据表明，rTOF房车的效率明显低于正常水平。
Repaired tetralogy of Fallot (rTOF) patients develop right ventricular (RV) dilatation and dysfunction. To prevent their demise, pulmonary valve replacement is necessary, though appropriate timing for it is challenged by a paucity of reliable diagnostic parameters. In this pilot study, we hypothesized that stroke work (SW) and energy calculations would delineate the inefficiency of RV performance in rTOF. RV SW was calculated for both an rTOF and a normal subject by utilizing RV pressure and volume measurements obtained during cardiac catheterization and MRI studies. Energy transfer rate and ratio were computed at the main pulmonary artery (PA). Compared to the normal RV, the rTOF RV had higher operating pressure, lower computed SW (0.078 J vs. 0.115 J for normal), and higher negative energy transfer at the PA (0.044 J vs. 0.002 J for normal). Furthermore, the energy transfer ratio was nearly twice as high for the normal RV (1.06) as for the rTOF RV (0.56). RV SW and energy transfer ratio delineate important operational efficiency differences in blood flow from the RV to the PA between rTOF and normal subjects. Our pilot data suggest that the rTOF RV is significantly less efficient than normal.