Right Atrial Evaluation in Patients With Pulmonary Hypertension A Real-time 3-Dimensional Transthoracic Echocardiographic Study
Right Atrial Evaluation in Patients With Pulmonary Hypertension A Real-time 3-Dimensional Transthoracic Echocardiographic Study
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DOI：
10.7863/ultra.15.01028
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发表时间：
2016-01-01
影响因子：
2.3
通讯作者：
He, Qun-yan
中科院分区：
文献类型：
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作者：
Deng, Yan;Guo, Sheng-lan;He, Qun-yan
目的-本研究的目的是通过实时 3 维超声心动图 (3DE) 探讨肺动脉高压患者右心室 (RV) 结构重塑继发的右心房 (RA) 形态特征和性能的变化。方法 - 对 112 名患者和 30 名健康对照参与者进行综合二维超声心动图和实时 3DE。肺动脉高压患者分为 3 个亚组： 1、右心室尺寸正常（n = 34）； 2、右心室扩大且收缩功能保留（n = 36）； 3，右心室扩大和收缩功能障碍（n = 42）。结果-与对照组相比，患者具有更大的 RA 体积参数和更低的 RA 被动排空分数（P < .01）。与对照组 (35.4% +/- 3.5%) 相比，患者第 1 组 (平均值 +/- SD，45.5% +/- 10.7%) 和第 2 组 (40.1% +/- 4.0%) 的 RA 主动排空分数较高，第 3 组 (19.3% +/- 4.3%) 较低。第 1 组和第 2 组的 RA 总排空分数相似（分别为 59.3% +/- 9.7% 和 52.6% +/- 3.4%），但与对照组相比，第 3 组显着较低（26.8% +/- 5.1% 对比 55.2% +/- 5.1%）。右心房容量和时相功能很大程度上受 RV 结构和功能的影响。结论 - 实时 3DE 是一种可行、可重复且无创的方法，用于获取周期性 RA 容量和功能变化，例如肺动脉高压患者中不同 RV 状态发生的变化。
Objectives-The purpose of this study was to investigate the changes in the morphologic characteristics and performance of the right atrium (RA) that occur secondary to structural remodeling of the right ventricle (RV) in patients with pulmonary hypertension by real-time 3-dimensional echocardiography (3DE).Methods-Comprehensive 2-dimensional echocardiography and real-time 3DE were performed in 112 patients and 30 healthy control participants. Patients with pulmonary hypertension were divided into 3 subgroups: 1, normal RV dimension (n = 34); 2, RV enlargement and preserved systolic function (n = 36); and 3, RV enlargement and systolic dysfunction (n = 42).Results-Patients had larger RA volume parameters and lower RA passive emptying fractions than controls (P < .01). The RA active emptying fraction was higher in patient groups 1 (mean +/- SD, 45.5% +/- 10.7%) and 2 (40.1% +/- 4.0%) and lower in group 3 (19.3% +/- 4.3%) compared to controls (35.4% +/- 3.5%). The RA total emptying fraction was similar between groups 1 and 2 (59.3% +/- 9.7% and 52.6% +/- 3.4%, respectively) but was significantly lower in group 3 compared to controls (26.8% +/- 5.1% versus 55.2% +/- 5.1%). Right atrial volume and phasic function were substantially affected by RV structure and function.Conclusions-Real-time 3DE is a feasible, repeatable, and noninvasive method for accessing cyclic RA volume and function changes, such as those that occur with varying RV status in patients with pulmonary hypertension.