Echocardiographic assessment of right ventricular contractile reserve in healthy subjects
Echocardiographic assessment of right ventricular contractile reserve in healthy subjects
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DOI：
10.1111/echo.13396
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发表时间：
2017-01-01
影响因子：
1.5
通讯作者：
Naeije, Robert
中科院分区：
文献类型：
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作者：
D'Alto, Michele;Pavelescu, Adriana;Naeije, Robert
研究背景手术诱导的肺动脉收缩压（PASP）升高作为右心室（RV）收缩储备的一个可能的指标，已被证明可预测重度肺动脉高压患者的生存率。然而，RV收缩储备也可以通过每搏输出量（SV）、三尖瓣环平面收缩期偏移（TAPSE）或三尖瓣环收缩期速度（S '）的变化来测量。正常值的限制和功能的意义，这些变化在健康subjects.MethodsIn这项前瞻性研究，90名健康受试者（45名男性，平均年龄39 - 13岁）进行运动负荷超声心动图测量TAPSE，S '，TAPSE/PASP，SV，PASP在休息和高峰运动。结果TAPSE、S '、PASP、SV、TAPSE/PASP的运动诱发性变化的正常值分别为4 ~ 10 mm、6 ~ 14 cm/s、12 ~ 57 mm Hg、0 ~ 96 mL、-1.2 ~0 mm/mm Hg。在运动高峰期，女性的TAPSE/PASP、PASP、S '和SV低于男性，但TAPSE/PASP高于男性。老化与TAPSE/PASP、TAPSE、S '、PASP和SV降低相关。此外，S '，TAPSE/PASP，PASP，SV，但不TAPSE，直接与最大workload.ConclusionsOur结果提供年龄和性别相关的限制正常RV收缩储备评估运动负荷超声心动图和证明RV收缩功能指数（PASP，TAPSE，S'，和TAPSE/PASP）与最大运动能力。
BackgroundExercise-induced increase in pulmonary artery systolic pressure (PASP) as a possible measure of right ventricular (RV) contractile reserve has been shown to predict survival in severe pulmonary hypertension. However, RV contractile reserve can also be measured by changes in stroke volume (SV), tricuspid annular plane systolic excursion (TAPSE), or tricuspid annular systolic velocity (S'). The limits of normal values and the functional significance of these changes in healthy subjects are not well known.MethodsIn this prospective study, 90 healthy subjects (45 male, mean age 39 13years) underwent exercise stress echocardiography with measurement of TAPSE, S', TAPSE/PASP, SV, and PASP at rest and peak exercise. Maximum and minimum normal values were reported for all indices.ResultsNormal values of exercise-induced changes () were 4 to 10mm for TAPSE, 6 to 14cm/s for S', 12 to 57mm Hg for PASP, 0 to 96mL for SV, and -1.2 to 0mm/mm Hg for TAPSE/PASP. At peak exercise, women showed lower TAPSE/PASP, PASP, S', and SV, but higher TAPSE/PASP than men. Aging was associated with decreased TAPSE/PASP, TAPSE, S', PASP, and SV. In addition, S', TAPSE/PASP, PASP, and SV, but not TAPSE, were directly correlated with maximum workload.ConclusionsOur results provide age- and sex-related limits of normal for RV contractile reserve as assessed by exercise stress echocardiography and demonstrate that RV systolic function indices (PASP, TAPSE, S', and TAPSE/PASP) correlate with maximum exercise capacity.