Grading right ventricular dysfunction in left ventricular disease using echocardiography: a proof of concept using a novel multiparameter strategy.
Grading right ventricular dysfunction in left ventricular disease using echocardiography: a proof of concept using a novel multiparameter strategy.
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DOI：
10.1002/ehf2.13448
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发表时间：
2021-08
影响因子：
3.8
通讯作者：
Bollano E
中科院分区：
文献类型：
--
作者：
Bech-Hanssen O;Astengo M;Fredholm M;Bergh N;Hjalmarsson C;Polte CL;Ricksten SE;Bollano E
左心室（LV）疾病患者的右心室功能障碍（RVD）分级很少受到关注。在本研究中，我们建立了超声心动图RVD评分，并研究了评分的增量如何对应于右心导管插入术中的RVD。我们纳入了95例连续转诊接受心脏移植或心力衰竭检查的LV疾病患者，这些患者在48小时内接受了导管插入术和超声心动图检查。RVD评分（5分）包括右心室（RV）功能从代偿性发展到失代偿性的众所周知的特征：肺动脉高压、RV应变降低、RV面积扩张、中度/重度三尖瓣返流和超声心动图显示的右心房压力（RAP）升高。比较RVD评分增加的三组[1（轻度）、2-3（中度）和4-5（重度）]，显示RVD更晚期，RV舒张末期压增加（P < 0.001），与负荷解耦的迹象（RV和肺动脉弹性之间的比值降低，P < 0.001），RV形状更球形（RV面积/长度，P < 0.001）。检测重度RV（RAP ≥ 10 mmHg）的受试者工作特征曲线分析显示，RVD评分的曲线下面积为0.88，而RV应变、三尖瓣环平面收缩期偏移和面积变化分数分别为0.69、0.68和0.64。RVD评分≥ 4的患者发生重度RVD的可能性增加6.7倍，RVD评分≤ 1的患者均未发生重度RVD。在这项概念验证研究中，一种新型RVD评分在RVD严重程度分级方面优于广泛使用的纵向参数，在心力衰竭患者的精确诊断、随访和预后评估中具有潜在作用。
Grading right ventricular dysfunction (RVD) in patients with left ventricular (LV) disease has earned little attention. In the present study, we established an echocardiographic RVD score and investigated how increments of the score correspond to RVD at right heart catheterization. We included 95 patients with LV disease consecutively referred for heart transplant or heart failure work‐up with catheterization and echocardiography within 48 h. The RVD score (5 points) included well‐known characteristics of the development from compensated to decompensated right ventricular (RV) function: pulmonary hypertension, reduced RV strain, RV area dilatation, moderate/severe tricuspid regurgitation, and increased right atrial pressure (RAP) by echocardiography. Comparing three groups with increments of RVD score [1 (mild), 2–3 (moderate), and 4–5 (severe)] showed more advanced RVD with increasing RV end‐diastolic pressure (P < 0.001) and signs of uncoupling to load (reduced ratio between RV and pulmonary artery elastance, P < 0.001) and more spherical RV shape (RV area/length, P < 0.001). Receiver operating characteristic curve analysis for detection of severe RV (RAP ≥ 10 mmHg) showed for the RVD score an area under the curve of 0.88 compared with 0.69, 0.68, and 0.64 for RV strain, tricuspid annular plane systolic excursion, and fractional area change, respectively. A patient with RVD score ≥ 4 had a 6.7‐fold increase in likelihood of severe RVD, and no patient with RVD score ≤ 1 had severe RVD. In this proof of concept study, a novel RVD score outperformed the widely used longitudinal parameters regarding grading of RVD severity, with a potential role for refined diagnosis, follow‐up, and prognosis assessment in heart failure patients.
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影响因子：
14
作者：
Lisi, Matteo;Cameli, Matteo;Henein, Michael Y.
通讯作者：
Henein, Michael Y.
DOI：
10.1016/j.echo.2016.05.002
发表时间：
2016-09-01
影响因子：
6.5
作者：
Kim, Jiwon;Srinivasan, Aparna;Weinsaft, Jonathan W.
通讯作者：
Weinsaft, Jonathan W.
影响因子：
24
作者：
Matthews, Jennifer Cowger;Koelling, Todd M.;Aaronson, Keith D.
通讯作者：
Aaronson, Keith D.
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
2.8
作者：
Ghio, S;Recusani, F;Tavazzi, L
通讯作者：
Tavazzi, L