Usefulness of right ventricular basal free wall strain by two-dimensional speckle tracking echocardiography in patients with chronic thromboembolic pulmonary hypertension.
Usefulness of right ventricular basal free wall strain by two-dimensional speckle tracking echocardiography in patients with chronic thromboembolic pulmonary hypertension.
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DOI：
10.1536/ihj.14-162
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发表时间：
2015
影响因子：
1.5
通讯作者：
K. Shiino;Kunihiko Sugimoto;A. Yamada;K. Takada;H. Kawai;K. Sugimoto;Hiroshi Takahashi;Y. Takagi;M. Iwase;Y. Ozaki
中科院分区：
文献类型：
--
作者：
K. Shiino;Kunihiko Sugimoto;A. Yamada;K. Takada;H. Kawai;K. Sugimoto;Hiroshi Takahashi;Y. Takagi;M. Iwase;Y. Ozaki
近年来，右心室游离壁的二维散斑跟踪超声心动图（STE）已被证明是一种非常有用的估计右心室功能的工具。本研究的目的是研究RV基底自由壁应变是否可以检测慢性血栓栓塞性肺动脉高压（CTEPH）患者的平均肺动脉压（mPAP）升高。我们共调查了126例CTEPH患者（平均年龄56±12岁）。他们接受了超声心动图和右心导管检查。在RV聚焦的根尖4室视图中，通过在RV基底自由壁上放置2个兴趣区（roi）来测量2D ste衍生的纵向应变。在2个roi之间获得峰值应变（RV-PS）。评估常规超声心动图右心室参数（右心室面积变化、右心室心肌表现指数、三尖瓣环平面收缩偏移、三尖瓣环峰值收缩速度、三尖瓣反流压力梯度）。超声心动图评估后第二天行右心导管。RV回声参数中，RV- ps与mPAP相关性最好（r = 0.75, P < 0.0001）。受试者工作特征分析显示，RV-PS -20.8%的临界值可检出mPAP≧25 mmHg（灵敏度78%，特异性93%，曲线下面积0.90,P < 0.001）。RV基底游离壁应变是CTEPH患者无创检测mPAP升高的有用工具。
Recently two-dimensional (2D) speckle tracking echocardiography (STE) derived from right ventricular (RV) free wall has been shown to be a very useful tool for the estimation of RV performance. The purpose of this study was to examine whether RV basal free wall strain can detect increased mean pulmonary arterial pressure (mPAP) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We investigated a total of 126 patients with CTEPH (mean age, 56 ± 12 years). They underwent echocardiography and right heart catheter examination. 2D STE-derived longitudinal strain was measured by placing 2 regions of interests (ROIs) on the RV basal free wall in RV-focused apical 4-chamber view. Peak strain (RV-PS) was acquired between the 2 ROIs. Conventional echocardiographic RV parameters (RV fractional area change, RV myocardial performance index, tricuspid annular plane systolic excursion, tricuspid annular peak systolic velocity, and tricuspid regurgitant pressure gradient) were evaluated as well. Right heart catheterization was performed on the day following of echocardiographic evaluation. Among RV echo parameters, RV-PS showed the best correlation with mPAP (r = 0.75, P < 0.0001). Receiver operating characteristic analysis revealed that a cut-off value of RV-PS -20.8% could detect mPAP ≧ 25 mmHg (sensitivity 78%, specificity 93%, area under the curve 0.90, P < 0.001). RV basal free wall strain was a useful tool for the non-invasive detection of increased mPAP in patients with CTEPH.