Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography
Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography
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DOI：
10.1093/ejechocard/jep149
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发表时间：
2010-01-01
影响因子：
--
通讯作者：
Hassager, Christian
中科院分区：
文献类型：
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作者：
Kjaergaard, Jesper;Iversen, Kasper K.;Hassager, Christian
急性右心室容量超负荷对右心室功能的影响知之甚少。我们通过在动物模型中应用新的心肌性能定量超声心动图标记物来评估急性重度肺动脉返流（PR）对整体和局部RV功能的影响。经胸超声心动图，包括用于评价局部纵向功能的组织多普勒超声心动图，通过在32头农场猪的肺动脉瓣环中部署支架诱导重度PR之前和之后立即进行。急性PR与RV几何结构的显著变化相关，表现为RV直径和面积分别增加22%和32%，P < 0.001，终末孔偏心指数增加21%，P < 0.0001。通过右心室短轴缩短率评估的右心室径向功能增加了18%，P = 0.03，而通过纵向功能评估的右心室射血分数的其他指标保持不变。纵向基础心肌等容加速度、收缩期峰值速度、应变率或应变无变化。RV似乎能很好地适应急性重度PR。尽管心腔几何结构发生了显著变化，但未观察到整体或局部纵向收缩力或变形的变化。径向缩短的增加可能意味着RV通过增加径向收缩作为扩张的辅助来进行补偿。
Little is known of the impact of acute right ventricular (RV) volume overload on RV function. We assessed the impact of acute severe pulmonary regurgitation (PR) on global and regional RV function by applying novel quantitative echocardiographic markers of myocardial performance in an animal model.Transthoracic echocardiography, including tissue-Doppler echocardiography for the evaluation of regional longitudinal function, was performed immediately before and after induction of severe PR by deployment of a stent in the pulmonary valve annulus of 32 farm pigs. Acute PR was associated with significant changes in RV geometry illustrated by an increase in RV diameter and area by 22 and 32%, respectively, P < 0.001 for both, and the eccentricity index increased by 21% in end-diastole, P < 0.0001. RV radial function as assessed by RV short-axis fractional shortening increased by 18%, P = 0.03, whereas other measures of RV ejection fraction by longitudinal function remained unchanged. There were no changes in the longitudinal basal myocardial isovolumic acceleration, peak systolic velocity, strain rate, or strain.The RV seems to accommodate well to acute severe PR. No changes in global or regional longitudinal contractility or deformation were observed despite significant changes in the cardiac chamber geometry. An increase in radial shortening may imply that the RV compensates by increasing radial contraction as an adjunct to dilatation.