Speckle-Tracking Echocardiographic Measures of Right Ventricular Diastolic Function Correlate with Reference Standard Measures Before and After Preload Alteration in Children.
Speckle-Tracking Echocardiographic Measures of Right Ventricular Diastolic Function Correlate with Reference Standard Measures Before and After Preload Alteration in Children.
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DOI：
10.1007/s00246-016-1479-3
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发表时间：
2017-01
影响因子：
1.6
通讯作者：
Mertens L
中科院分区：
文献类型：
--
作者：
Chowdhury SM;Goudar SP;Baker GH;Taylor CL;Shirali GS;Friedberg MK;Dragulescu A;Chessa KS;Mertens L
超声心动图测量右心室舒张功能的准确性研究很少。我们的目的是评估超声心动图和参考标准测量的相关性，这些测量来自于儿童预负荷改变前后的微压计压力分析。对接受右心导管置管的儿童，在给予液体丸前后进行超声心动图和微压计分析。测定等容松弛时间常数（tau）和舒张末期压（EDP）。观察常规超声心动图和斑点追踪超声心动图（STE）参数对右心室收缩和舒张功能的影响。给予生理盐水丸使右心室EDP增加20%。在22例先天性心脏病或心脏移植后患者中进行了28项研究。平均年龄8.7±6.1岁。左心室纵向舒张早期应变率（EDSR）与给药前（r = 0.57, p = 0.001）和给药后（r = 0.48, p = 0.008） tau相关。没有常规超声心动图测量与液体丸前后的tau相关。多元回归分析显示左室EDSR和左室周向EDSR是RV tau的独立预测因子。没有EDP的独立预测因子。RV EDSR似乎与儿童在基线和预负荷变化后早期活动性心室舒张的参考标准测量相关。常规超声心动图测量的舒张功能不能预测预负荷改变后的舒张功能。未来的研究应该评估STE测量舒张功能在这一人群中的预后意义。
The accuracy of echocardiographic measures of right ventricular (RV) diastolic function has been sparsely studied. Our objective was to evaluate the correlation between echocardiographic and reference standard measures of RV diastolic function derived from micromanometer pressure analysis before and after preload alteration in children. Echocardiograms and micromanometer pressure analyses were prospectively performed before and after fluid bolus in children undergoing right heart catheterization. The isovolumic relaxation time constant (tau) and end-diastolic pressure (EDP) were measured. Conventional and speckle-tracking echocardiographic (STE) parameters of RV systolic and diastolic function were assessed. Normal saline bolus was given to increase RV EDP by 20%. 28 studies were performed in 22 patients with congenital heart disease or post heart transplantation. Mean age was 8.7 ± 6.1 yrs. RV longitudinal early diastolic strain rate (EDSR) correlated with tau before (r = 0.57, p = 0.001) and after fluid bolus (r = 0.48, p = 0.008). No conventional echocardiographic measures correlated with tau both before and after fluid bolus. Multiple regression analysis revealed RV EDSR and LV circumferential EDSR as independent predictors of RV tau. There were no independent predictors of EDP. RV EDSR appears to correlate with the reference-standard measure of early active ventricular relaxation in children at baseline and after changes in preload. Conventional echocardiographic measures of diastolic function were not predictive of diastolic function after preload alteration. Future studies should assess the prognostic significance of STE measures of diastolic function in this population.