Usefulness of Bidimensional Strain Imaging for Predicting Outcome in Asymptomatic Patients Aged ≤ 16 Years With Isolated Moderate to Severe Aortic Regurgitation
Usefulness of Bidimensional Strain Imaging for Predicting Outcome in Asymptomatic Patients Aged ≤ 16 Years With Isolated Moderate to Severe Aortic Regurgitation
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DOI：
10.1016/j.amjcard.2012.05.039
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发表时间：
2012-10-01
影响因子：
2.8
通讯作者：
Russo, Maria Giovanna
中科院分区：
文献类型：
--
作者：
Di Salvo, Giovanni;Rea, Alessandra;Russo, Maria Giovanna
由于新的外科手术和血流动力学治疗方法的广泛应用，主动脉瓣反流（AR）在儿科人群中有所增加。不幸的是，AR患者的确切手术时间仍然存在争议。常规超声心动图参数、左室尺寸和左室射血分数在预测早期左室功能障碍方面存在局限性。二维应变成像是一种新兴的超声技术，有可能更好地研究这些患者。本研究的目的是评估二维纵向应变在先天性孤立性中重度AR年轻患者中的预后价值。研究了26例无症状AR年轻患者（3至16岁）。平均随访时间为2.9±1.2年（0.5 ~ 6年）。采用斑点追踪和常规超声心动图对病情稳定的患者与进展性AR（定义为出现症状，左室容积增加>= 15%，或左室射血分数下降-19.5%，敏感性77.8%，特异性94.1%，曲线下面积0.889）患者的基线左室功能进行比较。综上所述，二维应变成像可以区分进行性AR的年轻无症状患者，这可以让年轻AR患者在发生不可逆心肌损伤之前更好地确定手术时间。(C) 2012爱思唯尔公司版权所有。（美国医学杂志2012；110:1051-1055）
Aortic regurgitation (AR) has increased in the pediatric population because of the expanded use of new surgical and hemodynamic procedures. Unfortunately, the exact timing for operation in patients with AR is still debated. Conventional echocardiographic parameters, left ventricular (LV) dimensions and the LV ejection fraction, have limitations in predicting early LV dysfunction. Two-dimensional strain imaging, an emerging ultrasound technology, has the potential to better study those patients. The aim of this study was to assess the prognostic value of 2-dimensional longitudinal strain in young patients with congenital isolated moderate to severe AR. Twenty-six young patients with asymptomatic AR (aged 3 to 16 years) were studied. The mean follow-up duration was 2.9 +/- 1.2 years (range 0.5 to 6). Baseline LV function by speckle-tracking and conventional echocardiography in patients with stable disease was compared with that in patients with progressive AR (defined as development of symptoms, increase in LV volume >= 15%, or decrease in the LV ejection fraction -19.5%, sensitivity 77.8%, specificity 94.1%, area under the curve 0.889). In conclusion, 2-dimensional strain imaging can discriminate young asymptomatic patients with progressive AR. This could allow young patients with AR to have a better definition of surgical timing before the occurrence of irreversible myocardial damage. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:1051-1055)