Reversible Right Ventricular Regional Non-Uniformity Quantified by Speckle-Tracking Strain Imaging in Patients With Acute Pulmonary Thromboembolism
Reversible Right Ventricular Regional Non-Uniformity Quantified by Speckle-Tracking Strain Imaging in Patients With Acute Pulmonary Thromboembolism
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DOI：
10.1016/j.echo.2009.09.005
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发表时间：
2009-12-01
影响因子：
6.5
通讯作者：
Ito, Masaaki
中科院分区：
文献类型：
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作者：
Sugiura, Emiyo;Dohi, Kaoru;Ito, Masaaki
背景：本研究的目的是利用斑点追踪应变分析评估急性肺血栓栓塞症（APTE）患者急性右心室（RV）压力超负荷（RVPO）对右心室收缩功能及其区域均匀性的影响。方法：对23名APTE患者（平均年龄59±6±16岁）和23名年龄匹配、性别匹配的正常受试者（对照组）进行超声心动图检查。使用斑点跟踪应变超声心动图分析整体和节段纵向 RV 峰值收缩应变 (PSS)。通过计算 6 段 PSS 的标准差除以全局 PSS 的绝对值来评估 RV 区域功能的异质性。使用 6 个节段从 QRS 开始到 PSS 的心率校正间隔的标准差来量化 RV 不同步。结果：APTE 患者局部 PSS 降低，导致整体 PSS 降低和区域异质性增强，并且 RV 基底和中部侧壁的心肌收缩延迟，导致较大的不同步（整体 PSS，-14 +/- vs -25 +/- 3%；异质性，0.54） +/- 0.26 vs 0.24 +/- 0.09；不同步，91 +/- 38 vs 25 +/- 10 ms；所有比较的 P < .05）。通过初步治疗改善急性 RVPO 后，RV 异质性和不同步性均恢复到正常值。结论：斑点追踪应变超声心动图可以有效量化急性 RVPO 引起的可逆性 RV 区域不均匀性，并可以表征 APTE 患者的 RV 区域损伤模式。 （J Am Soc Echocardiogr 2009；22：1353-9。）
Background: The aim of this study was to evaluate the effects of acute right ventricular (RV) pressure overload (RVPO) on RV systolic function and its regional uniformity using speckle-tracking strain analysis in patients with acute pulmonary thromboembolism (APTE).Methods: Twenty-three patients with APTE (mean age, 59 6 16 years) and 23 age-matched and gender-matched normal subjects (the control group) were examined using echocardiography. Global and segmental longitudinal RV peak systolic strain (PSS) was analyzed using speckle-tracking strain echocardiography. The heterogeneity of RV regional function was assessed by calculating the standard deviation from 6-segmental PSS divided by the absolute value of global PSS. The standard deviation of the heart rate-corrected intervals from QRS onset to PSS for the 6 segments was used to quantify RV dyssynchrony.Results: Patients with APTE had reduced regional PSS, resulting in reduced global PSS and augmented regional heterogeneity, and had delayed myocardial contraction in the basal and mid RV lateral walls, resulting in large dyssynchrony (global PSS, -14 +/- vs -25 +/- 3%; heterogeneity, 0.54 +/- 0.26 vs 0.24 +/- 0.09; dyssynchrony, 91 +/- 38 vs 25 +/- 10 ms; P < .05 vs controls for all comparisons). After the amelioration of acute RVPO by primary treatment, both RV heterogeneity and dyssynchrony returned to normal values.Conclusion: Speckle-tracking strain echocardiography can effectively quantify reversible RV regional nonuniformity caused by acute RVPO and can characterize the pattern of RV regional impairment in patients with APTE. (J Am Soc Echocardiogr 2009;22:1353-9.)