Left ventricular torsion rate and the relation to right ventricular function in pediatric pulmonary arterial hypertension.
Left ventricular torsion rate and the relation to right ventricular function in pediatric pulmonary arterial hypertension.
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DOI：
10.1177/2045894018791352
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发表时间：
2018-07
影响因子：
2.6
通讯作者：
Kheyfets VO
中科院分区：
文献类型：
--
作者：
Dufva MJ;Truong U;Tiwari P;Ivy DD;Shandas R;Kheyfets VO
右心室和左心室通过室间隔物理耦合。因此，一个心室的几何形状和力学变化可以直接影响另一个心室的功能。在小儿肺动脉高压的治疗中，左心室常常被忽视，临床主要关注改善右心室功能。小儿肺动脉高压是一种在病因学和生存率上与成人肺动脉高压不同的疾病。我们的目的是评估小儿肺动脉高压的左心室扭转率及其在右心室功能障碍中的作用。前瞻性采集了18例儿童肺动脉高压（WHO I级）患者和17例无已知心肺疾病的对照受试者的心脏磁共振图像和组织标记。肺动脉高压队列在有临床指征的右心导管插入术后48小时内接受心脏磁共振检查。使用右心导管数据，我们计算了右心室收缩末期弹性（作为右心室收缩力的测量）和心室血管耦合比（收缩末期弹性/动脉后负荷）的单次搏动估计。左心室扭转率量化标记心脏磁共振图像的谐波相位分析。心室和肺动脉压力和肺血管阻力来自右心导管数据。右心室射血分数和室间隔曲率来自心脏磁共振。肺动脉高压组左室扭转率明显低于对照组（1.40 ± 0.61° vs.3.02 ± 1.47°，P < 0.001）。肺动脉高压患儿左室扭转率降低与右室收缩力（收缩末期弹性）降低（r = 0.61，P = 0.007），右室收缩压升高（r =-0.54，P = 0.021）相关。在肺动脉高压和对照组中，左室扭转率与右室射血分数相关（对照组r = 0.45，P = 0.034）（肺动脉高压r = 0.57，P = 0.032）。肺动脉高压组室间隔曲率与右室收缩压呈正相关（r = 0.7，P = 0.001），与左室扭转率呈负相关（r =-0.57，P = 0.013）。左室扭转率与心室血管耦联比呈正相关（r = 0.54，P = 0.021），与平均肺动脉压（r =-0.60，P = 0.008）、肺血管阻力（r =-0.47，P = 0.049）呈负相关。我们的结论是，在小儿肺动脉高压，右心室收缩力降低与左心室扭转率降低。
The right ventricle and left ventricle are physically coupled through the interventricular septum. Therefore, changes in the geometry and mechanics of one ventricle can directly affect the function of the other. In treatment of pediatric pulmonary arterial hypertension, the left ventricle is often overlooked, with clinical focus primarily on improving right ventricular function. Pediatric pulmonary arterial hypertension represents a disease distinct from adult pulmonary arterial hypertension based on etiology and survival rates. We aimed to assess left ventricular torsion rate in pediatric pulmonary arterial hypertension and its role in right ventricular dysfunction. Cardiac magnetic resonance images with tissue tagging were prospectively acquired for 18 pediatric pulmonary arterial hypertension (WHO class I) patients and 17 control subjects with no known cardiopulmonary disease. The pulmonary arterial hypertension cohort underwent cardiac magnetic resonance within 48 hours of clinically indicated right heart catheterization. Using right heart catheterization data, we computed single beat estimation of right ventricular end-systolic elastance (as a measure of right ventricular contractility) and ventricular vascular coupling ratio (end-systolic elastance/arterial afterload). Left ventricular torsion rate was quantified from harmonic phase analysis of tagged cardiac magnetic resonance images. Ventricular and pulmonary pressures and pulmonary vascular resistance were derived from right heart catheterization data. Right ventricular ejection fraction and interventricular septum curvature were derived from cardiac magnetic resonance. Left ventricular torsion rate was significantly reduced in pulmonary arterial hypertension patients compared to control subjects (1.40 ± 0.61° vs. 3.02 ± 1.47°, P < 0.001). A decrease in left ventricular torsion rate was significantly correlated with a decrease in right ventricular contractility (end-systolic elastance) (r = 0.61, P = 0.007), and an increase in right ventricular systolic pressure in pulmonary arterial hypertension kids (r = –0.54, P = 0.021). In both pulmonary arterial hypertension and control subjects, left ventricular torsion rate correlated with right ventricular ejection fraction (controls r = 0.45, P = 0.034) (pulmonary arterial hypertension r = 0.57, P = 0.032). In the pulmonary arterial hypertension group, interventricular septum curvature demonstrated a strong direct relationship with right ventricular systolic pressure (r = 0.7, P = 0.001) and inversely with left ventricular torsion rate (r = –0.57, P = 0.013). Left ventricular torsion rate showed a direct relationship with ventricular vascular coupling ratio (r = 0.54, P = 0.021), and an inverse relationship with mean pulmonary arterial pressure (r = –0.60, P = 0.008), and pulmonary vascular resistance (r = –0.47, P = 0.049). We conclude that in pediatric pulmonary arterial hypertension, reduced right ventricular contractility is associated with decreased left ventricular torsion rate.
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DOI：
10.1016/j.echo.2013.10.002
发表时间：
2014-01-01
影响因子：
6.5
作者：
Kaku, Kyoko;Takeuchi, Masaaki;Otsuji, Yutaka
通讯作者：
Otsuji, Yutaka
影响因子：
168.9
作者：
Berger, Rolf M. F.;Beghetti, Maurice;Humpl, Tilman;Raskob, Gary E.;Ivy, D. Dunbar;Jing, Zhi-Cheng;Bonnet, Damien;Schulze-Neick, Ingram;Barst, Robyn J.
通讯作者：
Barst, Robyn J.
影响因子：
6
作者：
Klima, UP;Lee, MY;Vlahakes, GJ
通讯作者：
Vlahakes, GJ
影响因子：
37.8
作者：
FOGEL, MA;WEINBERG, PM;HOFFMAN, EA
通讯作者：
HOFFMAN, EA
影响因子：
9.7
作者：
Aronson, Doron;Eitan, Amnon;Burger, Andrew J.
通讯作者：
Burger, Andrew J.