Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparisonwith cardiac magnetic resonance
Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparisonwith cardiac magnetic resonance
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DOI：
10.1093/ehjci/jeu156
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发表时间：
2015-01-01
影响因子：
6.2
通讯作者：
Mondillo, Sergio
中科院分区：
文献类型：
--
作者：
Focardi, Marta;Cameli, Matteo;Mondillo, Sergio
目的右心室分数面积变化（RVFAC）、三尖瓣收缩运动的组织多普勒和m型测量[三尖瓣Sm和三尖瓣环平面收缩偏移（TAPSE）]以及三维超声心动图是目前量化右心室收缩功能的无创方法；通过斑点跟踪超声心动图（STE）分析右心室变形最近允许分析右心室的性能。本研究以心脏磁共振（CMR）为参考标准，探讨传统超声心动图参数（分数缩短、s’RV、TAPSE）与创新超声心动图参数（应变）与CMR测量的右心室射血分数（RVEF）的相关性。方法与结果对63例临床评价患者行CMR及经胸超声多普勒检查。怀疑为心肌炎21例，特发性扩张型心肌病8例，肥厚型心肌病10例，心律失常性右室发育不良（ARVD） 10例，浸润性心肌病5例，其他原因9例。采用磁共振成像（MRI）测量RVEF。计算所有患者的RVFAC、三尖瓣S′和TAPSE。通过平均grvfree - wallrvls （free-wallRVLS）和平均所有节段（globalRVLS）来评估stevrv纵向应变（RVLS）。应用roc分析方法评价诊断的准确性。TAPSE、三尖瓣S′和全局RVLS与RVEF呈良好的相关性（r = 0.45、r = 0.52和r = 20.71; P = 0.01）。自由壁RVLS、RVFAC与RVEF密切相关（r = 20.86、r = 0.77, P < 0.0001）。此外，自由壁RVLS在预测RVEF降低方面表现出最高的诊断准确性[曲线下面积（AUC） 0.92]，良好的敏感性和特异性分别为96%和93%
Aims Right ventricle fractional area change (RVFAC), tissue Doppler and M-mode measurements of tricuspid systolic motion [tricuspid Sm and tricuspid annular plane systolic excursion (TAPSE)], and 3D echocardiography are the current noninvasive methods for the quantification of RV systolic function; RV deformation analysis by speckle-tracking echocardiography (STE) has recently allowed the analysis of RV performance. Using cardiac magnetic resonance (CMR) as the reference standard, this study aimed at exploring the correlation between the traditional (fractional shortening, s'RV, TAPSE) and innovative (strain) echocardiographic parameters and RV ejection fraction (RVEF) measured by CMR.Methods and results CMR and transthoracic echo-Doppler were performed in 63 patients referred for clinical assessment. Twenty-one presented the suspicion of myocarditis, 8 presented idiopathic dilated cardiomyopathy, 10 hypertrophic cardiomyopathy, 10 arrhythmogenic right ventricular dysplasia (ARVD), 5 infiltrative cardiomyopathy, and 9 other reasons. RVEF was measured by magnetic resonance imaging (MRI). RVFAC, tricuspid S', and TAPSE were calculated in all patients. RV longitudinal strain (RVLS) by STEwas assessed by averagingRVfree-wall segments (free-wallRVLS) and by averaging all segments (globalRVLS). TheROCanalysiswas applied for the assessment of diagnostic accuracy. Goodcorrelationswere found for TAPSE, tricuspid S', and global RVLS with RVEF (r = 0.45, r = 0.52, and r = 20.71, respectively; P = 0.01 for all). Close correlations between free-wall RVLS and RVFAC with RVEF were found (r = 20.86 and r = 0.77, respectively; P < 0.0001 for both). Furthermore, free-wall RVLS demonstrated the highest diagnostic accuracy [area under curve (AUC) 0.92] and good sensitivity and specificity of 96 and 93%, respectively, to predict reduced RVEF