Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring

被引：169

作者：

Giusca, S. ^{[1
]}

Dambrauskaite, V. ^{[1
]}

Scheurwegs, C. ^{[1
]}

D'hooge, J. ^{[1
]}

Claus, P. ^{[1
]}

Herbots, L. ^{[1
]}

Magro, M. ^{[1
]}

Rademakers, F. ^{[1
]}

Meyns, B. ^{[2
]}

Delcroix, M. ^{[3
]}

Voigt, J-U ^{[1
]}

机构：

[1] Catholic Univ Louvain, Dept Cardiol, Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium

[2] Catholic Univ Louvain, Dept Cardiac Surg, Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium

[3] Catholic Univ Louvain, Dept Pulmonol, Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium

来源：

HEART | 2010年 / 96卷 / 04期

关键词：

STRAIN-RATE; PULMONARY ENDARTERECTOMY; ECHOCARDIOGRAPHY; HYPERTROPHY; PRESSURE;

D O I：

10.1136/hrt.2009.171728

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To quantify right ventricular (RV) function in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after pulmonary endarterectomy (PEA). Methods Out of 33 patients, 16 were evaluated clinically and with echocardiography (conventional and myocardial deformation parameters) before PEA (preop) and at 1 week, 1 month, 3 months and 6 months after PEA. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE) as well as mid-apical and basal peak ejection strain (S) and strain rate (SR) of the RV free wall were measured. Left ventricular (LV) apical lateral wall motion was regarded as indicating changes in overall heart rocking motion (RM). Heart catheterisation was performed before, within 1 week and at 6 months after PEA. Results Clinical and haemodynamic parameters improved significantly after PEA. This correlated with the improvement in RVFAC, S and SR. TAPSE, on the other hand, showed a biphasic response (14.5 (4) mm preop, 8.5 (2.7) mm at 1 week and 11 (1.5) mm at 6 months). Changes in LV apical motion explain this finding. At baseline, TAPSE was enhanced by rocking motion of the heart as a result of the failing RV. Unloading the RV by PEA normalised the rocking motion and TAPSE decreased. Conclusions RV function of CTEPH patients improves steadily after PEA. Unlike S, SR and RVFAC, this is not reflected by TAPSE because of postoperative changes in overall heart motion. Motion independent deformation parameters (S, SR) appear superior in the accurate description of regional RV function

引用

页码：281 / 288

页数：8

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