Role of Serial Quantitative Assessment of Right Ventricular Function by Strain in Pulmonary Arterial Hypertension
Role of Serial Quantitative Assessment of Right Ventricular Function by Strain in Pulmonary Arterial Hypertension
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DOI：
10.1016/j.amjcard.2012.08.061
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发表时间：
2013-01-01
影响因子：
2.8
通讯作者：
Kane, Garvan C.
中科院分区：
文献类型：
--
作者：
Hardegree, Evan L.;Sachdev, Arun;Kane, Garvan C.
本研究的目的是评估基于散斑应变成像的右心室 (RV) 功能的连续定量评估是否受到肺动脉高压特异性治疗的影响，以及 RV 应变的连续变化与临床状态之间是否存在相关性。使用斑点追踪超声心动图对 50 名肺动脉高压 (PAH) 患者在开始治疗之前和之后评估 RV 纵向收缩功能。平均随访间隔为 6 +/- 2 个月。随后评估了 4 年的生存情况。患者的 RV 收缩压平均从 PAH 治疗前的 -15 +/- 5 增加至 -20 +/- 7% (p = 0.0001)。游离壁收缩应变持续或严重降低（= RV 游离壁收缩应变改善 5%，4 年时死亡率风险降低七倍以上（风险比 0.13，95% 置信区间 0.03 至 0.50，p = 0.003）。总之，通过定量应变成像对 RV 纵向收缩功能进行连续超声心动图评估可独立预测患者的临床恶化和死亡率接受药物治疗后患有肺动脉高压 (c) 2013 年，Elsevier Inc. 出版（Am J Cardiol 2013；111:143-148）
The aim of this study was to assess whether serial quantitative assessment of right ventricular (RV) function by speckle-based strain imaging is affected by pulmonary hypertension-specific therapies and whether there is a correlation between serial changes in RV strain and clinical status. RV longitudinal systolic function was assessed using speckle-tracking echocardiography in 50 patients with pulmonary arterial hypertension (PAH) before and after the initiation of therapy. The mean interval to follow-up was 6 +/- 2 months. Subsequent survival was assessed over 4 years. Patients demonstrated a mean increase in RV systolic strain from -15 +/- 5 before to -20 +/- 7% (p = 0.0001) after PAH treatment. Persistence of or progression to a severe reduction in free wall systolic strain (= 5% improvement in RV free wall systolic strain had a greater than sevenfold lower mortality risk at 4 years (hazard ratio 0.13, 95% confidence interval 0.03 to 0.50, p = 0.003). In conclusion, serial echocardiographic assessment of RV longitudinal systolic function by quantitative strain imaging independently predicts clinical deterioration and mortality in patients with PAH after the institution of medical therapy. (c) 2013 Published by Elsevier Inc. (Am J Cardiol 2013;111:143-148)