组织多普勒成像技术评价肺动脉高压患者右心功能的研究
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摘要
目的:分析运用组织多普勒(TDI)成像技术TDI-Tei指数评价肺动脉高压患者右心室心功能的价值。方法:选择临床疑诊为肺动脉高压(PH)患者110例进行右心导管检查,测量肺动脉收缩压(PASP),并将其分为无PH组及轻度PH组、中度PH组、重度PH组。组织多普勒在心尖四腔心切面三尖瓣前瓣附着处记录三尖瓣环运动频谱并测算右心室Tei指数。结果:肺动脉高压患者右心室功能整体降低,右心室Tei指数升高,且与肺动脉收缩压呈正相关(r=0.75,P<0.05)。TDI-Tei指数可以灵敏地反映肺动脉高压患者右心室功能的变化。结论:TDI-Tei指数测量简单易行,可敏感、客观地评估PH所致的右心室收缩功能下降。
Objective:To explore the change of right ventricular function in patients with pulmonary hypertension(PH)by Tei index obtained from tissue Doppler imaging(TDI).Methods:Right cardiac catheterization was performed in 110 patients who were suspected with pulmonary hypertension and the patients were divided into 4 groups according to the level of pulmonary hypertension.Tei index of right ventricle was obtained by TDI from the anterior tricuspid annulus in apical four chamber view.Results:Tei index of right ventricle in patients with pulmonary hypertension was higher than that of the control group significantly(P<0.05).A better correlation was observed between Tei index of right ventricle and pulmonary arterial systolic pressure(r=0.75,P<0.05).Conclusion:Tei index of right ventricle significantly increased in PH patients and was positively correlated with pulmonary artery systolic pressure.
Objective:To explore the change of right ventricular function in patients with pulmonary hypertension(PH)by Tei index obtained from tissue Doppler imaging(TDI).Methods:Right cardiac catheterization was performed in 110 patients who were suspected with pulmonary hypertension and the patients were divided into 4 groups according to the level of pulmonary hypertension.Tei index of right ventricle was obtained by TDI from the anterior tricuspid annulus in apical four chamber view.Results:Tei index of right ventricle in patients with pulmonary hypertension was higher than that of the control group significantly(P<0.05).A better correlation was observed between Tei index of right ventricle and pulmonary arterial systolic pressure(r=0.75,P<0.05).Conclusion:Tei index of right ventricle significantly increased in PH patients and was positively correlated with pulmonary artery systolic pressure.
引文
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[13]李雪梅,冯新恒,李敬府,等.组织多普勒成像技术对肺动脉高压患者右心室功能的评价[J].中国超声医学杂志,2017,33(5):470-472.
[14]HARADA K,TAMURA M,TOYONO M,et al.Comparison of the rig ht ventricular Tei index by tissue Doppler imaging to that obtained by pulsed Doppler in children without heart disease[J].Am JCardiol,2002,90(5):566-569.
[15]周小燕,王新房,谢明星,等.Tei指数评价右心容量和压力负荷过重对房间隔缺损患者心功能的影响[J].中华超声影像学杂志,2007,16(2):116-119.
[2]BEIGEL R,CERCEK B,LUO H,et al.Nonin vasiveevaluation of right atrial pressure[J].J Am Soc Echocardiogr,2013,26(9):1033-1042.
[3]BLEASDALE R A,FRENNEAUX M P.Prognostic importance of right ventricular dysfunction[J].Heart,2002,88(4):323-324.
[4]李越.肺动脉压力的超声心动图评估[J].中华医学超声杂志(电子版),2012,9(2):98-102.
[5]GALIN,HOEPER M M,HUMBERT M,et al.Guidelines for the diagnosis and treatment of pulmonary hypertension[J].Eur Respir J,2009,34(6):1219-1263.
[6]张兰,任建丽,王志刚.超声新技术评估肺动脉高压患者右心功能研究进展[J].中国医学影像技术,2014,30(5):794-797.
[7]RUDSKI L G,LAI W W,AFILALO J,et al.Guidelines for the echocardiographic assessment of the right heart in adults:a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography[J].J Am Soc Echocardiogr,2010,23(7):685-713.
[8]VORHIES E E,GAJARSKI R J,YU S,et al.Echocardiographic evaluation of ventricular function in children with pulmonary hypertension[J].Pediatr Cardiol,2014,35(5),759-766.
[9]OGIHARA Y,YAMADA N,DOHI K,et al.Utility of right ventricular Tei-index for assessing disease severity and determining response to treatment in patients with pulmonary arterial hypertension[J].JCardiol,2013,63(2):149-153.
[10]HILDE J M,SKJARTEN I,GRATTA O J,et al.Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension[J].J Am Coll Cardiol,2013,62(12):1103-1111.
[11]SHIMONY A,FOX B D,AFILALO J,et al.Pulmonary arterial hypertension in the elderly clinical characteristics and long-term survival[J].Lung,2012,190(6):645-649.
[12]俞霏,尹凤英,陈立斌,等.超声心动图评估慢性阻塞性肺疾患者的右心收缩功能改变[J].中国超声医学杂志,2014,30(2):121-125.
[13]李雪梅,冯新恒,李敬府,等.组织多普勒成像技术对肺动脉高压患者右心室功能的评价[J].中国超声医学杂志,2017,33(5):470-472.
[14]HARADA K,TAMURA M,TOYONO M,et al.Comparison of the rig ht ventricular Tei index by tissue Doppler imaging to that obtained by pulsed Doppler in children without heart disease[J].Am JCardiol,2002,90(5):566-569.
[15]周小燕,王新房,谢明星,等.Tei指数评价右心容量和压力负荷过重对房间隔缺损患者心功能的影响[J].中华超声影像学杂志,2007,16(2):116-119.