AN ECHOCARDIOGRAPHIC INDEX FOR SEPARATION OF RIGHT VENTRICULAR VOLUME AND PRESSURE OVERLOAD
AN ECHOCARDIOGRAPHIC INDEX FOR SEPARATION OF RIGHT VENTRICULAR VOLUME AND PRESSURE OVERLOAD
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DOI：
10.1016/s0735-1097(85)80433-2
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发表时间：
1985-01-01
影响因子：
24
通讯作者：
ARMSTRONG, WF
中科院分区：
文献类型：
--
作者：
RYAN, T;PETROVIC, O;ARMSTRONG, WF
室间隔异常运动已被描述为右心室容量和压力过载的超声心动图特征。为了确定二维超声心动图是否可以区分这两个实体，并将它们与正常情况区分开来，我们对12名正常受试者和35名接受心导管插入术的患者进行了左心室短轴视图下室间隔的几何形状和运动进行了评估。在35例患者中，13例无合并性房间隔缺损伴右心室容积超载，但肺动脉压未升高。其余22例肺动脉收缩压大于40 mm Hg，为右室压过负荷组。在收缩期终末和舒张期终末分别测定2条垂直的小轴直径的长度之比，其中1条垂直于室间隔。在所有正常受试者中，收缩期末和舒张期末的偏心指数基本上都是1.0，如果左心室腔在短轴视图中呈圆形，则可以预期。在右心室容量过载的患者中，收缩期末偏心率指数约为1.0，舒张末期偏心率指数显著升高（平均偏心率指数= 1.26 +-）。0.12) （p < 0.001）。右心室压力过载的患者，收缩期末和舒张期末的偏心指数均显著大于1.0（1.44 +-）。0.16和1.26 .+-。0.11) （P < 0.001）左心室形状偏心指标可以明显反映室间隔的异常运动。该指标易于获得，可将正常受试者、右心室容量过负荷患者和右心室压力过负荷患者分开。
Abnormal motion of the interventricular septum has been described as an echocardiographic feature of both right ventricular volume and pressure overload. To determine if 2-dimensional echocardiography can separate these 2 entities and distinguish them from normal, geometry and motion of the interventricular septum in short-axis views of the left ventricle were evaluated in 12 normal subjects and 35 patients undergoing cardiac catheterization. Of the 35 patients 13 had uncomplicated atrial septal defect with associated right ventricular volume overload, but no elevation in pulmonary artery pressure. The 22 remaining patients had a pulmonary artery systolic pressure greater than 40 mm Hg and constituted the group with right ventricular pressure overload. An eccentricity index, defined as the ratio of the length of 2 perpendicular minor-axis diameters, 1 of which bisected and was perpendicular to the interventricular septum, was obtained at end-systole and end-diastole. In all normal subjects, the eccentricity index at both end-systole and end-diastole was essentially 1.0, as would be expected if the left ventricular cavity was circular in the short-axis view. In patients with right ventricular volume overload, the eccentricity index was approximately 1.0 at end-systole, but was significantly increased at end-diastole (mean eccentricity index = 1.26 .+-. 0.12) (P < 0.001). In patients with right ventricular pressure overload, the eccentricity index was significantly greater than 1.0 at both end-systole and end-diastole (1.44 .+-. 0.16 and 1.26 .+-. 0.11, respectively) (P < 0.001) An index of eccentric left ventricular shape which reflects abnormal motion of the interventricular septum apparently can be defined. This index is easily obtained and allows separation of normal subjects, patients with right ventricular volume overload and patients with right ventricular pressure overload.