Transthoracic echocardiography in children and young adults with congenital heart disease.
Transthoracic echocardiography in children and young adults with congenital heart disease.
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DOI：
10.5402/2012/753481
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Koestenberger M
中科院分区：
文献类型：
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作者：
Koestenberger M
经胸超声心动图（TTE）是诊断和随访小儿和年轻成人先天性心脏病（CHD）患者的一线工具。适当使用TTE可以减少对更具侵入性的方式的需求，如心导管插入术和心脏磁共振成像。最近出现了新的超声心动图技术：组织多普勒成像、组织跟踪（应变和应变率）、矢量速度成像（VVI）、心肌性能指数、等容加速（IVA）期间的心肌加速度、收缩期与舒张期持续时间的比值（S/D比值）以及收缩期右心室（RV）功能的二维测量（例如，三尖瓣环平面收缩期偏移，TAPSE）。这些可能成为心室性能、顺应性和疾病进展的有价值的指标。此外，用于评估瓣膜功能、器械位置和心室容积的三维（3D）超声心动图正被纳入常规临床护理。在本文中，潜在的使用和限制这些新的超声心动图技术在冠心病患者进行了讨论。特别关注的是在与右心室容积增加相关的情况下（例如，法洛四联症修复后的肺返流）或压力（例如，肺动脉高压）。
Transthoracic echocardiography (TTE) is the first-line tool for diagnosis and followup of pediatric and young adult patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged more recently: tissue Doppler imaging, tissue tracking (strain and strain rate), vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic acceleration (IVA), the ratio of systolic to diastolic duration (S/D ratio), and two dimensional measurements of systolic right ventricular (RV) function (e.g., tricuspid annular plane systolic excursion, TAPSE). These may become valuable indicators of ventricular performance, compliance, and disease progression. In addition, three-dimensional (3D) echocardiography when performed for the assessment of valvular function, device position, and ventricular volumes is being integrated into routine clinical care. In this paper, the potential use and limitations of these new echocardiographic techniques in patients with CHD are discussed. A particular focus is on the echocardiographic assessment of right ventricular (RV) function in conditions associated with increased right ventricular volume (e.g., pulmonary regurgitation after tetralogy of Fallot repair) or pressure (e.g., pulmonary hypertension) in children and young adults.