Assessment of right ventricular longitudinal strain by 2D speckle tracking imaging compared with RV function and hemodynamics in pulmonary hypertension
Assessment of right ventricular longitudinal strain by 2D speckle tracking imaging compared with RV function and hemodynamics in pulmonary hypertension
复制标题
肺动脉高压患者右心室纵向应变的二维散斑跟踪成像与右心室功能和血流动力学比较的评估
DOI：
10.1007/s10554-017-1182-3
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发表时间：
2017-11-01
影响因子：
2.1
通讯作者：
Lu, Xiuzhang
中科院分区：
文献类型：
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作者：
Li, Yidan;Wang, Yidan;Lu, Xiuzhang
研究肺动脉高压(PH)患者的右心室纵向应变(RVLS)及其与超声心动图测量的RV功能参数和右心导管测量的血流动力学参数的关系。根据WHO功能分级（FC），66例PH患者分为FC I/II（第1组）和III/IV（第2组）。通过超声心动图检查测量右心室功能参数。通过右心导管插入术获得血流动力学参数。第2组患者的肺动脉收缩压（sPAP；P< 0.05）高于第（1）组患者，在整体RVLS（RVLSglobal）、游离壁RVLS（RVLSFW；P< 0.01）和RV常规功能参数（均P< 0.05）方面观察到组间显着差异。 (2)组中mPAP和PVR显着升高，CI显着降低。RVLSglobal与6分钟步行距离(6MWD;r= 0.492,P< 0.001)和N端脑钠肽前体(NT-proBNP;r= 0.632,P< 0.001)呈正相关，RVLSFW与6MWD (r= 0.483,P< 0.001) 和 NT-proBNP (r= 0.627,P< 0.001)。血流动力学分析显示，RVLSglobal与mPAP（r= 0.594，P< 0.001）、PVR（r= 0.573，P< 0.001）和CI（r= 0.366，P= 0.003）呈正相关，RVLSFW与mPAP呈正相关。 （r= 0.597，P< 0.001），PVR（r= 0.577，P< 0.001）和CI（r= 0.369，P= 0.002）。根据受试者工作特征曲线，RVLSglobal（–15.0%）和RVLSFW（–15.3%）的最佳临界值用于预后检测，具有良好的敏感性和特异性。有证据表明，RVLS 测量可以提供有关 RV 功能和血流动力学的急需且可靠的信息。因此，这对于 PH 患者的临床管理来说是一种患者友好的方法。
The right ventricular longitudinal strain (RVLS) of pulmonary hypertension (PH) patients and its relationship with RV function parameters measured by echocardiography and hemodynamic parameters measured by right heart catheterization was investigated. According to the WHO functional class (FC), 66 PH patients were divided into FC I/II (group 1) and III/IV (group 2). RV function parameters were measured by echocardiographic examinations. Hemodynamic parameters were obtained by right heart catheterization. Patients in group 2 had higher systolic pulmonary artery pressure (sPAP;P< 0.05) than patients in group (1) significant between-group differences were observed in global RVLS (RVLSglobal), free wall RVLS (RVLSFW;P< 0.01), and RV conventional function parameters (allP< 0.05). Moreover, mPAP and PVR increased remarkably and CI decreased significantly in group (2) RVLSglobalhad a positive correlation with 6-min walking distance (6MWD;r= 0.492,P< 0.001) and N-terminal pro-brain natriuretic peptide (NT-proBNP;r= 0.632,P< 0.001), while RVLSFWhad a positive correlation with 6MWD (r= 0.483,P< 0.001) and NT-proBNP (r= 0.627,P< 0.001). Hemodynamics analysis revealed that RVLSglobalhad a positive correlation with mPAP (r= 0.594,P< 0.001), PVR (r= 0.573,P< 0.001) and CI (r= 0.366,P= 0.003), while RVLSFWhad a positive correlation with mPAP (r= 0.597,P< 0.001), PVR (r= 0.577,P< 0.001) and CI (r= 0.369,P= 0.002). According to receiver operating characteristic curves, the optimal cut-off values of RVLSglobal(–15.0%) and RVLSFW(–15.3%) for prognosis detection with good sensitivity and specificity. Evidence has shown that RVLS measurement can provide the much-needed and reliable information on RV function and hemodynamics. Therefore, this qualifies as a patient-friendly approach for the clinical management of PH patients.