Comparison of Right Versus Left Ventricular Strain Analysis as a Predictor of Outcome in Patients With Systolic Heart Failure Referred for Heart Transplantation
Comparison of Right Versus Left Ventricular Strain Analysis as a Predictor of Outcome in Patients With Systolic Heart Failure Referred for Heart Transplantation
复制标题
DOI：
10.1016/j.amjcard.2013.07.046
复制
发表时间：
2013-12-01
影响因子：
2.8
通讯作者：
Mondillo, Sergio
中科院分区：
文献类型：
--
作者：
Cameli, Matteo;Righini, Francesca Maria;Mondillo, Sergio
本研究的目的是探讨右心室（RV）和左心室（LV）超声心动图参数与转诊心脏移植的晚期心力衰竭患者临床结果之间的关系。连续九十八名晚期收缩性心力衰竭患者被转诊进行心脏移植评估。所有患者均接受前瞻性随访，观察新结局事件的发生情况，包括因急性心力衰竭住院、心血管死亡、心脏移植、主动脉内球囊泵植入和心室辅助装置植入。对所有受试者进行常规经胸超声心动图检查。通过对心尖 4 腔视图中的所有节段进行平均（全局 RVLS）和对 RV 游离壁节段进行平均（游离壁 RVLS），评估斑点跟踪超声心动图的 RV 纵向应变（RVLS）。还计算了 LV 整体纵向应变和整体周向应变。在 98 名基线受试者中，有 46 名受试者在平均 1.5 +/- 0.9 年的随访期间发生了 67 起新事件。游离壁 RVLS、整体 RVLS、激素原脑利钠肽 N 端片段、RV 面积分数变化和 LV 舒张末期容积可独立预测综合结果（所有 p
The aim of the present study was to explore the relation between right ventricular (RV) and left ventricular (LV) echocardiographic parameters with clinical outcome in patients with advanced heart failure referred for cardiac transplantation. Ninety-eight consecutive patients with advanced systolic heart failure, referred for cardiac transplant evaluation, were enrolled. All patients were prospectively followed for the development of new outcome events, which included hospitalization for acute heart failure, cardiovascular death, heart transplantation, intra-aortic balloon pump implantation, and ventricular assist device implantation. Conventional transthoracic echocardiography was performed in all subjects. RV longitudinal strain (RVLS) by speckle-tracking echocardiography was assessed by averaging all segments in apical 4-chamber view (global RVLS) and by averaging RV free-wall segments (free-wall RVLS). LV global longitudinal and global circumferential strains were also calculated. Of the 98 subjects at baseline, 46 had 67 new events during a mean follow-up of 1.5 +/- 0.9 years. Free-wall RVLS, global RVLS, N-terminal fragment of the prohormone brain natriuretic peptide, RV fractional area change, and LV end-diastolic volume were independently predictive of combined outcomes (all p