单位:[1]Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China[2]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China[3]National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
Right ventricular (RV) function is a significantly important factor in the determination of the prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) patients. Speckle-tracking echocardiography (STE) is an angle-independent new technique for quantifying myocardial deformation that is capable of providing data on multiple parameters including longitudinal and transverse information of the myocardium. In the present study, we aimed to study the advantages of STE-derived parameters in identifying RV dysfunction in CTEPH patients. Sixty CTEPH patients (mean age: 55years +/- 13 years; 25 males) and 30 normal controls (mean age: 54years +/- 14 years; 14 males) were enrolled in this study. RV free wall (RVFW) systolic peak longitudinal strain (LS) including the basal, mid-, and apical-segments and the basal longitudinal and transverse displacement (basal-DL and basal-DT) were measured by STE. Global LS (GLS) of the RV was calculated by averaging the LS value of the 3 segments of RVFW. Clinical data of CTEPH patients were collected. CTEPH patients were divided into 2 subgroups according to the World Health Organization function classification. Clinical right heart failure (RHF) was defined as the presence of symptoms of heart failure and signs of systemic circulation congestion during hospitalization. The apical segment LS of the RVFW was lower than that in the basal and mid-segments in the control group (P<0.001), but no significant difference was found among the 3 segments of LS in the CTEPH group (P=0.263). When we used the cutoff value recommended by the American Society of Echocardiography guidelines to identify abnormal RV function, 30 CTEPH patients (50%) by tricuspid annular plane systolic excursion (TAPSE), 42 patients (70%) by fractional area change (FAC), 20 patients (33.33%) by RV index of myocardial performance (RVIMP), and 46 patients (77%) patients by GLS were determined to have abnormal RV function, respectively. Among multiple RV function indicators, TAPSE, FAC, GLS, basal-DL, and N-terminal pronatriuretic B-type natriuretic peptide showed significant differences between CTEPH patients with mild (WHO II) and severe symptoms (WHO III/IV) (all P<0.001), while RVIMP and basal-DT showed no significant difference (P=0.188 and P=0.394, respectively). Pearson correlation analysis showed that GLS has no correlation with sPAP as evaluated by echocardiography in CTEPH patients (r = -0.079, P=0.574), and a weak to moderate correlation with RA area (r=0.488, P=0.000), the RV diameter (r=0.429, P=0.001), and the RVFW thickness (r=0.344, P=0.009). On receiver operating characteristic analysis, GLS has the largest area under the curve to identify RHF when the cutoff value was -13.45%, the sensitivity was 78.2%, and the specificity was 84.6%, separately. Our study demonstrated that the depression of regional LS of RVFW is more pronounced in the basal and middle segments in CTEPH patients. Also, the longitudinal movement is much more important than the transverse movement when evaluating RV systolic function. As compared with conventional parameters, RVFW GLS showed more sensitivity to identify abnormal RV function and had the largest AUC for identifying RHF. Additionally, GLS showed no correlation with sPAP and a weak correlation with right heart morphological parameters in our CTEPH cohort.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81570049]; Beijing Natural Science FoundationBeijing Natural Science Foundation [7152062]; National Key Research and Development Program of China [2016YFC0905600]; China-Japan Friendship Hospital research project [2015-1-MS-1]
语种:
外文
被引次数:
WOS:
中科院(CAS)分区:
出版当年[2017]版:
大类|4 区医学
小类|4 区心脏和心血管系统4 区核医学
最新[2025]版:
大类|4 区医学
小类|4 区心脏和心血管系统4 区核医学
JCR分区:
出版当年[2016]版:
Q3RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGINGQ3CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q3CARDIAC & CARDIOVASCULAR SYSTEMSQ3RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
第一作者单位:[1]Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China
通讯作者:
推荐引用方式(GB/T 7714):
Li Ai-Li,Zhai Zhen-Guo,Zhai Ya-Nan,et al.The value of speckle-tracking echocardiography in identifying right heart dysfunction in patients with chronic thromboembolic pulmonary hypertension[J].INTERNATIONAL JOURNAL of CARDIOVASCULAR IMAGING.2018,34(12):1895-1904.doi:10.1007/s10554-018-1423-0.
APA:
Li, Ai-Li,Zhai, Zhen-Guo,Zhai, Ya-Nan,Xie, Wan-Mu,Wan, Jun&Tao, Xin-Cao.(2018).The value of speckle-tracking echocardiography in identifying right heart dysfunction in patients with chronic thromboembolic pulmonary hypertension.INTERNATIONAL JOURNAL of CARDIOVASCULAR IMAGING,34,(12)
MLA:
Li, Ai-Li,et al."The value of speckle-tracking echocardiography in identifying right heart dysfunction in patients with chronic thromboembolic pulmonary hypertension".INTERNATIONAL JOURNAL of CARDIOVASCULAR IMAGING 34..12(2018):1895-1904