Magnetic resonance imaging of the right ventricle in pediatric pulmonary arterial hypertension.
Magnetic resonance imaging of the right ventricle in pediatric pulmonary arterial hypertension.
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DOI：
10.4103/2045-8932.114763
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发表时间：
2013-04
影响因子：
2.6
通讯作者：
Feinstein J
中科院分区：
文献类型：
--
作者：
Blalock S;Chan F;Rosenthal D;Ogawa M;Maxey D;Feinstein J
肺动脉高压 (PAH) 会导致右心室 (RV) 发生变化，影响右心室的大小和功能，最终导致死亡。这些变化已通过心脏 MRI (CMR) 对成人 PAH 患者进行了评估，但尚未对儿童进行评估。使用 PAH 儿科患者的 CMR，我们检查了 RV 大小和功能（1）与正常数据相比，（2）随时间的变化，以及（3）与成年人群中的类似研究进行比较。对两个机构的数据进行了回顾性审查。患有 PAH 和 CMR 的受试者也被纳入其中。将基线 CMR 变量（以体表面积为索引的右心室和左心室舒张末期和收缩末期容积，以及计算的每搏输出量和射血分数）与标准数据和后续 CMR 数据进行比较。包括 26 名患有特发性 PAH 的受试者（15 名女性），年龄 2-16（平均 11）岁。所有患者均接受 PAH 药物治疗，其中 65% 接受前列环素治疗。基线 6 分钟步行距离（6MWD；481 ± 137）正常。与正常数据相比，右心室容量和射血分数明显异常（P < 0.001）。对 15 名患者的随访 CMR 进行了分析。一年内右心室容量和功能以及左心室每搏输出量没有显着变化。根据 CMR 检测，我们的 PAH 儿科患者右心室明显异常，但步行距离正常。 CMR 参数在一年内没有变化可能代表了一个稳定的队列，并且与成人的类似研究不同。
Pulmonary arterial hypertension (PAH) causes changes in the right ventricle (RV), affecting RV size and function, ultimately leading to death. These changes have been evaluated by cardiac MRI (CMR) in adults with PAH, but not in children. Using CMR in pediatric patients with PAH, we examined how RV size and function (1) compare to normal data, (2) change over time, and (3) compare to similar studies in the adult population. Data from two institutions were retrospectively reviewed. Subjects with PAH and a CMR were included. Baseline CMR variables (right and left ventricular end-diastolic and end-systolic volumes indexed for body surface area, and calculated stroke volume and ejection fraction) were compared to normative data and follow-up CMR data. Twenty-six subjects (15 female), age 2-16 (mean 11) years, with idiopathic PAH were included. All patients were on PAH medication, and 65% on prostacyclin therapy. The baseline 6-Minute Walk Distance (6MWD; 481 ± 137) was normal. RV volumes and ejection fraction were markedly abnormal compared to normal data (P < 0.001). Follow-up CMRs were analyzed in 15 patients. RV volumes and function and LV stroke volume showed no significant change over one year. Our pediatric patients with PAH have markedly abnormal right ventricles by CMR but have normal walk distances. The lack of change in CMR parameters over one year may represent a stable cohort and is different than similar studies in adults.
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