Disturbed right ventricular diastolic function in patients with systemic 14 sclerosis -: A Doppler tissue imaging study
Disturbed right ventricular diastolic function in patients with systemic 14 sclerosis -: A Doppler tissue imaging study
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DOI：
10.1378/chest.128.2.755
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发表时间：
2005-08-01
期刊：
影响因子：
9.6
通讯作者：
Kazzam, E
中科院分区：
文献类型：
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作者：
Lindqvist, P;Caidahl, K;Kazzam, E
背景：系统性硬化症(SSC)患者的心肺受累预后不良，主要是由于肺动脉高压和紧张性心力衰竭。到目前为止，轻型脑室(RV)受累还没有详细的研究。因此，我们评估了SSc患者的右室功能，并将研究结果与疾病的临床特征相关联。方法：26例SSc患者(平均年龄为56-15岁[+/-SD])和25名年龄匹配的健康对照组(21名女性)进行了研究。应用多普勒超声心动图包括多普勒组织成像技术评价心功能。结果：与对照组相比，右室游离壁厚度(5.8±-1.7 mm vs 3.7±-1.1 mm，p<；0.001)和右房收缩面积(15.9±/-3.7 cm(2)vs 13.0+/-2.3 cm(2)，P<；舒张期/心房早期血流速度比值降低(1.2+/-0.4vs1.7+/-0.6，p<；0.01)。与对照组相比，患者的整体等容松弛时间[23ms vs 39+/-13ms，p&t；0.001]和局部等容松弛时间(83+/-40ins vs 46+/-24ms，p<；0.001)延长，而右室整体充盈时间缩短(454+/-122ins vs 548104ins，p<；0.001)。两组患者的右室收缩功能和静息时的肺压力相似，但患者组的肺动脉加速时间较对照组缩短(119+/-34INS比141+/-29INS，p<；0.05)。两组间左心功能无明显差异。结论：SSc患者右室舒张期功能改变，右室壁厚度和右室面积增加。这些发现似乎是右室功能障碍的早期标志，可能是对间歇性肺动脉高压的反应。
Background: Cardiopulmonary involvement in patients with systemic sclerosis (SSc) carries a poor prognosis, mainly due to pulmonary hypertension and tight-heart failure. To date, light ventricular (RV) involvement has not been studied in detail. We therefore assessed RV function in patients with SSc and related the findings to the clinical features of the disease.Method: Twenty-six consecutive patients (21 women) with SSc (mean age, 56 15 years [+/- SD]) and 25 healthy, age-matched control subjects (21 women) were studied. Doppler echocardiography including Doppler tissue imaging was used to evaluate cardiac function. Pulmonary function was also studied.Results: Compared with control subjects, RV free wall thickness (5.8 +/- 1.7 mm vs 3.7 +/- 1.1 mm, p < 0.001) and right atrial (RA) systolic area (15.9 +/- 3.7 cm(2) vs 13.0 +/- 2.3 cm(2), P < 0.01) were increased in patients with SSc, while the global early diastolic/atrial component velocity ratio was reduced (1.2 +/- 0.4 vs 1.7 +/- 0.6, p < 0.01). The global isovolumic relaxation time (IVRT) [64 23 ms vs 39 +/- 13 ms, p < 0.001] and regional IVRT (83 +/- 40 ins vs 46 +/- 24 ms, p < 0.001) were prolonged in patients vs control subjects, whereas the RV global filling time was reduced (454 +/- 122 ins vs 548 104 ins, p < 0.01). RV systolic function and pulmonary pressures at rest were similar in the two groups, but the pulmonary artery acceleration time was reduced (119 +/- 34 ins vs 141 +/- 29 ins, p < 0.05) in patients compared to control subjects. Left ventricular function did not differ between the two groups.Conclusion: Patients with SSc exhibit altered RV diastolic function together with an increase in RV wall thickness and RA area. These findings appear to be early markers of RV disturbance, probably in response to intermittent pulmonary arterial hypertension.