无创评估法洛四联症患儿右心室功能的探讨
|
摘要
研究背景：
先前研究表明：右心室功能正常与否直接影响着整个循环系统的功能,在相当多的先天性和获得性心脏病中右心室功能不全对预后起主要作用。法洛四联症(Tetralogy of Fallot, TOF)是最常见的青紫型先天性心脏病,近年来手术治疗预后明显改善,但术后远期随访右心功能不全的发生率仍高达38.2%,TOF病人术前及术后长期随访中右室功能评价在临床上非常重要。由于右心室形态复杂,临床上一直缺乏一种无创、准确、快速的评价方法指导病人在恰当的时期进行手术或治疗以避免右心室功能的进一步恶化。组织多普勒超声技术及应变、应变率成像直接从心肌组织提取信号,不需要对心脏几何形态进行假设,在各种心血管疾病中已有广泛的应用。与TDI在非先天性心脏病中的大量应用研究相比而言,TDI在先天性心脏病中的研究非常有限,而且几乎没有前瞻性研究。血浆B型尿钠肽(brain natriuretic peptide, BNP)是心室功能不全和应力改变的心肌标记物,随着容量负荷和压力负荷的增加而增加,可用于诊断右心功能不全。应用TDI及衍生的应变、应变率成像成像评价TOF病人的右心功能,并与常用的心功能指标比较,探讨其与血浆B型尿钠肽原N末端肽(N-terminal pro-brain natriuretic peptide, NT-ProBNP)及右心室重构病理改变的关系目前尚未见报道。
目的：
运用TDI技术及衍生的应变、应变率成像对法洛四联症患儿术前及术后短期随访的右心功能进行评价,并与心导管指标、NT-proBNP、心肌及血浆MMPs比较,探索能无创准确评价右心功能的指标,用于指导法洛四联症患儿右心功能的诊断、治疗和随访,并探讨TOF患儿右心室重构对右心功能的影响。
方法：
确诊为法洛四联症的患儿37例为TOF组,其中成功施行手术并随访6个月到1年的32例患儿作为TOF6组,将年龄和体表面积与TOF组患儿匹配的正常儿童37例为对照组。TOF组和对照组进行全面的超声心动图检查及心功能评估；静息状态下抽取静脉血2ml,免疫荧光法定量血浆NT-proBNP浓度,并在TOF6组中重复上述检查。TOF组中20例行心导管检查,测定各心腔压力和左、右心室射血分数。收集术中切除的新鲜右心室流出道心肌,用ILISA及免疫组化分别测量血浆MMP9及心肌组织MMP9和MMP2的IOD值
结果：
1.传统超声心动图评价TOF组患儿术前及术后左右心室的收缩、舒张功能未见明显改变；TDI和应变、应变率成像显示：与对照组比较,术前的TOF组患儿左心功能、右心功能较正常对照组降低,表现为：与对照组比较,TOF组左、右室游离壁的收缩功能指标(Sm、SRs、S)、最大收缩期位移(D)均显著降低；舒张功能指标异常,表现为Em、Em/Am、Sre降低及E／Em升高；TOF组右心室的收缩期峰值前移,射血时间缩短；右心室的E／Em比值与右心室舒张末压明显相关,而传统的超声心动图指标与心导管指标无关。在术后短期随访中,左心室功能恢复到正常水平,而右心室功能未见改善。
2.血浆NT-proBNP浓度与性别、年龄未见明显相关性。TOF组、TOF6组的Log NT-proBNP较正常对照组明显增高,有显著性差异；而前两组之间未见显著性差异。NT-proBNP测值与TDI测量的左心室游离壁基底部心肌舒张末期峰值流速(LVAm)明显相关；与右心室游离壁中间段的收缩期应变、应变率有一定相关；术前的NT-proBNP测值与TOF患儿手术停机时的中心静脉压明显相关；与心导管测定各腔的压力及心功能无关。
3.TOF组心肌的MMP9和MMP2的IOD值呈明显相关；TOF组心肌MMP9-IOD值与年龄明显相关,与二维超声心动图Simpson法测量的右心室射血分数明显负相关。TOF组心肌的MMP2-IOD值与右心室游离壁中间段的收缩期应变率呈明显负相关,与手术停机时中心静脉压正相关。血清MMP9-IOD值与血浆NT-proBNP测值、LogNT-proBNP值呈明显正相关。
结论：
我们的研究表明,TDI技术及衍生的应变、应变率成像能无创评估左、右心室功能,较传统超声心动图指标更敏感；在临床上无症状或轻微症状的TOF患儿中用TDI技术及衍生的应变、应变率成像诊断的右心功能不全与血浆NT-proBNP、MMP9水平增高一致。因此联合这些简单的指标将有助于诊断右心功能不全。TOF组患儿右心室的结构和功能的变化可能与心肌间质重构和金属基质蛋白酶的改变有关。
Background:
Previous studies have consistently revealed a central role for RV dysfunction in the prognosis and outcomes for a wide variety of acquired and congenital cardiac conditions. TOF is the most common cause of cyanotic congenital heart disease(CHD). Although TOF can be repaired surgically, the rate of progressive right ventricular(RV) dysfunction after operatidon reachs to 38.2%. The assessment of RV function is important in the management in TOF before operation and follow-up after operation. Yet, owing to its complex crescentic shape, the RV prove difficult to accurately and reproducibly assess. Reliable, noninvasive evaluation of right ventricular function, enable the identification of TOF with impaired cardiac function before they become clinically symptomatic is required. Tissue Doppler imaging(TDI)、strain rate and strain analysis (a measure of deformation that can be derived from TDI data, may represent a new, powerful method for quantifying regional myocardial function and is less influenced by tethering effects than TDI) have the potential to assess ventricular function independent of the shape of the ventricle. It has been used widely in many acquired heart dieases, however, there is few report, especially preceding study about the technique used in CHD. Brain natriuretic peptide (BNP) is a marker of ventricular dysfunction and wall stress.It is well-recognized that BNP is raised in conditions with ventricular volume and pressure overload and has a diagnostic role in RV dysfunction. Up to now, It has few reported that TDI, strain rate and strain analysis derived from TDI have been used to assess the RV function in TOF patients before operation and early after repair of TOF, correlate with neurohormonal activation:N-terminal proBNP levels (NT-proBNP) and pathologic transform of the remodel of RV.
Objectives:
This study was designed to evaluate the indices obtained by TDI、strain rate and strain analysis and correlate these indices with neurohormonal activation:Plasma NT-proBNP levels, matrix metalloproteittases of plasma and cardiac muscle in TOF, The indices will be used as a non-invasive important indices of right ventricular dysfunction to diagnose, treatment and follow-up of RV function in patients with TOF.
Methods:
Thirty-seven children with TOF were included in the study as a TOF group, Thirty-two children of them who had been surgically repaired TOF served as a TOF6 group, Thirty-seven age-and body surface area (BSA)-matched healthy children served as a control group. Comprehensive echocardiographic examination were done to evaluate left and right ventricular function in the two groups. Peripheral venous blood samples were obtained from all participants.After a rest of 15 minutes, the blood samples were immediately placed on ice and subsequently centrifuged at 5,000 rpm for 10 minutes. Plasma were stored at 80℃until further analysis. Concentrations of plasma NT-proBNP was determined using an immunoassay. Six months to one year, echocardiographic examinationin and Plasma NT-proBNP survey were repeat in the surgically repaired TOF(TOF6 group). A subset of 20 patients had invasive measurement of pressure of every cavity and ejection fraction (EF) of LV and RV. Plasma mmp9 were measured by ELISA and IOD of mmp-9 and mmp-2 of myocardium obtained from patients of TOF were measured by immunohistochemistry.
Result:
1. The left and right ventricular function in TOF patients had not changed significantly showed in traditional echocardiographic parameters compared to control group; The results of TDI, strain rate and strain analysis derived from TDI showed that the systolic and diastolic function index of RV and LV were decreased before operation--- Systolic function index of RV and LV:peak systolic velocity (Sm), peak systolic strain rate (SRs), systolic strain (ε) and systolic excursion(D) by tissue tracking (TT) were reduced in the mid segments of free wall in patients with TOF compared to controls; Diastolic function index:early diastolic velocity (Em), Em/Am, peak early diastolic SR (Sre) were reduced, E/Em (the ratio of the peak transmitral flow velocity during early diastole (E) to the peak annular velocity during early diastole (Em) obtained by TDI) were increased in patients with TOF compared to the control group; The Time from onset of QRS to Sm (Q-Sm) and the ejection time of RV were reduced and myocardial relaxation time was longer. TDI showed that RV E/Em significantly correlated with RV end diastolic pressure (RVDP), however, the RV conventional echocardiographic parameters did not correlate with any invasive measure of RV function. Six months to one year after surgically repaired TOF, the index of systolic and diastolic function of LV were declined to normal, but the index of systolic and diastolic function of RV were not improved in the TOF6 group.
2. There was no correlation of NT-proBNP to age and gender. Levels of NT-proBNP were elevated in the patients with TOF before and early after operation than control group. Howere, there was no significant difference between before and early after operation in TOF. Plasma NT-proBNP levels correlated significantly with LVAm obtained by TDI, SRs andεin the mid segments of free wall of RV obtained by strain rate and strain analysis and significantly correlated with central vena press(CVP) just after operation, but no correlated with the pressure of any cavity and EF of RV.
3. IOD of mmp-2 of myocardium was significantly correlated IOD of mmp-9 of myocardium. IOD of mmp-9 or mmp-2 of myocardium was significantly negative correlated with Simpson's biplane RVEF and SRs in the mid segments of free wall of RV; postive correlated with the age of the patient and CVP just after operation. Level of plasma mmp9 was increased in TOF group than control group and significantly correlated with level of plasma NT-proBNP and LogNT-proBNP.
Conclusion:
Our group recently demonstrated that TDI variables, SR and Strain analysis derived from TDI data has the potential to assess RV function, appeared to be more sensitive indicators of RV myocardial dysfunction than conventional indices of RV function.RV dysfunction detected by TDI variables, SR and Strain analysis determination in asymptomatic or minimally symptomatic TOF patients correlated well with plasma NT-proBNP and IOD of mmp9. Thus, these simple non-invasive methods can be used additionally to help in assessing RV function in TOF with impaired cardiac function before they become clinically symptomatic. The increasing of MMPs expression in the plasma and myocardia have a relation to the structure and function of right ventricular remodeling in TOF.
先前研究表明：右心室功能正常与否直接影响着整个循环系统的功能,在相当多的先天性和获得性心脏病中右心室功能不全对预后起主要作用。法洛四联症(Tetralogy of Fallot, TOF)是最常见的青紫型先天性心脏病,近年来手术治疗预后明显改善,但术后远期随访右心功能不全的发生率仍高达38.2%,TOF病人术前及术后长期随访中右室功能评价在临床上非常重要。由于右心室形态复杂,临床上一直缺乏一种无创、准确、快速的评价方法指导病人在恰当的时期进行手术或治疗以避免右心室功能的进一步恶化。组织多普勒超声技术及应变、应变率成像直接从心肌组织提取信号,不需要对心脏几何形态进行假设,在各种心血管疾病中已有广泛的应用。与TDI在非先天性心脏病中的大量应用研究相比而言,TDI在先天性心脏病中的研究非常有限,而且几乎没有前瞻性研究。血浆B型尿钠肽(brain natriuretic peptide, BNP)是心室功能不全和应力改变的心肌标记物,随着容量负荷和压力负荷的增加而增加,可用于诊断右心功能不全。应用TDI及衍生的应变、应变率成像成像评价TOF病人的右心功能,并与常用的心功能指标比较,探讨其与血浆B型尿钠肽原N末端肽(N-terminal pro-brain natriuretic peptide, NT-ProBNP)及右心室重构病理改变的关系目前尚未见报道。
目的：
运用TDI技术及衍生的应变、应变率成像对法洛四联症患儿术前及术后短期随访的右心功能进行评价,并与心导管指标、NT-proBNP、心肌及血浆MMPs比较,探索能无创准确评价右心功能的指标,用于指导法洛四联症患儿右心功能的诊断、治疗和随访,并探讨TOF患儿右心室重构对右心功能的影响。
方法：
确诊为法洛四联症的患儿37例为TOF组,其中成功施行手术并随访6个月到1年的32例患儿作为TOF6组,将年龄和体表面积与TOF组患儿匹配的正常儿童37例为对照组。TOF组和对照组进行全面的超声心动图检查及心功能评估；静息状态下抽取静脉血2ml,免疫荧光法定量血浆NT-proBNP浓度,并在TOF6组中重复上述检查。TOF组中20例行心导管检查,测定各心腔压力和左、右心室射血分数。收集术中切除的新鲜右心室流出道心肌,用ILISA及免疫组化分别测量血浆MMP9及心肌组织MMP9和MMP2的IOD值
结果：
1.传统超声心动图评价TOF组患儿术前及术后左右心室的收缩、舒张功能未见明显改变；TDI和应变、应变率成像显示：与对照组比较,术前的TOF组患儿左心功能、右心功能较正常对照组降低,表现为：与对照组比较,TOF组左、右室游离壁的收缩功能指标(Sm、SRs、S)、最大收缩期位移(D)均显著降低；舒张功能指标异常,表现为Em、Em/Am、Sre降低及E／Em升高；TOF组右心室的收缩期峰值前移,射血时间缩短；右心室的E／Em比值与右心室舒张末压明显相关,而传统的超声心动图指标与心导管指标无关。在术后短期随访中,左心室功能恢复到正常水平,而右心室功能未见改善。
2.血浆NT-proBNP浓度与性别、年龄未见明显相关性。TOF组、TOF6组的Log NT-proBNP较正常对照组明显增高,有显著性差异；而前两组之间未见显著性差异。NT-proBNP测值与TDI测量的左心室游离壁基底部心肌舒张末期峰值流速(LVAm)明显相关；与右心室游离壁中间段的收缩期应变、应变率有一定相关；术前的NT-proBNP测值与TOF患儿手术停机时的中心静脉压明显相关；与心导管测定各腔的压力及心功能无关。
3.TOF组心肌的MMP9和MMP2的IOD值呈明显相关；TOF组心肌MMP9-IOD值与年龄明显相关,与二维超声心动图Simpson法测量的右心室射血分数明显负相关。TOF组心肌的MMP2-IOD值与右心室游离壁中间段的收缩期应变率呈明显负相关,与手术停机时中心静脉压正相关。血清MMP9-IOD值与血浆NT-proBNP测值、LogNT-proBNP值呈明显正相关。
结论：
我们的研究表明,TDI技术及衍生的应变、应变率成像能无创评估左、右心室功能,较传统超声心动图指标更敏感；在临床上无症状或轻微症状的TOF患儿中用TDI技术及衍生的应变、应变率成像诊断的右心功能不全与血浆NT-proBNP、MMP9水平增高一致。因此联合这些简单的指标将有助于诊断右心功能不全。TOF组患儿右心室的结构和功能的变化可能与心肌间质重构和金属基质蛋白酶的改变有关。
Background:
Previous studies have consistently revealed a central role for RV dysfunction in the prognosis and outcomes for a wide variety of acquired and congenital cardiac conditions. TOF is the most common cause of cyanotic congenital heart disease(CHD). Although TOF can be repaired surgically, the rate of progressive right ventricular(RV) dysfunction after operatidon reachs to 38.2%. The assessment of RV function is important in the management in TOF before operation and follow-up after operation. Yet, owing to its complex crescentic shape, the RV prove difficult to accurately and reproducibly assess. Reliable, noninvasive evaluation of right ventricular function, enable the identification of TOF with impaired cardiac function before they become clinically symptomatic is required. Tissue Doppler imaging(TDI)、strain rate and strain analysis (a measure of deformation that can be derived from TDI data, may represent a new, powerful method for quantifying regional myocardial function and is less influenced by tethering effects than TDI) have the potential to assess ventricular function independent of the shape of the ventricle. It has been used widely in many acquired heart dieases, however, there is few report, especially preceding study about the technique used in CHD. Brain natriuretic peptide (BNP) is a marker of ventricular dysfunction and wall stress.It is well-recognized that BNP is raised in conditions with ventricular volume and pressure overload and has a diagnostic role in RV dysfunction. Up to now, It has few reported that TDI, strain rate and strain analysis derived from TDI have been used to assess the RV function in TOF patients before operation and early after repair of TOF, correlate with neurohormonal activation:N-terminal proBNP levels (NT-proBNP) and pathologic transform of the remodel of RV.
Objectives:
This study was designed to evaluate the indices obtained by TDI、strain rate and strain analysis and correlate these indices with neurohormonal activation:Plasma NT-proBNP levels, matrix metalloproteittases of plasma and cardiac muscle in TOF, The indices will be used as a non-invasive important indices of right ventricular dysfunction to diagnose, treatment and follow-up of RV function in patients with TOF.
Methods:
Thirty-seven children with TOF were included in the study as a TOF group, Thirty-two children of them who had been surgically repaired TOF served as a TOF6 group, Thirty-seven age-and body surface area (BSA)-matched healthy children served as a control group. Comprehensive echocardiographic examination were done to evaluate left and right ventricular function in the two groups. Peripheral venous blood samples were obtained from all participants.After a rest of 15 minutes, the blood samples were immediately placed on ice and subsequently centrifuged at 5,000 rpm for 10 minutes. Plasma were stored at 80℃until further analysis. Concentrations of plasma NT-proBNP was determined using an immunoassay. Six months to one year, echocardiographic examinationin and Plasma NT-proBNP survey were repeat in the surgically repaired TOF(TOF6 group). A subset of 20 patients had invasive measurement of pressure of every cavity and ejection fraction (EF) of LV and RV. Plasma mmp9 were measured by ELISA and IOD of mmp-9 and mmp-2 of myocardium obtained from patients of TOF were measured by immunohistochemistry.
Result:
1. The left and right ventricular function in TOF patients had not changed significantly showed in traditional echocardiographic parameters compared to control group; The results of TDI, strain rate and strain analysis derived from TDI showed that the systolic and diastolic function index of RV and LV were decreased before operation--- Systolic function index of RV and LV:peak systolic velocity (Sm), peak systolic strain rate (SRs), systolic strain (ε) and systolic excursion(D) by tissue tracking (TT) were reduced in the mid segments of free wall in patients with TOF compared to controls; Diastolic function index:early diastolic velocity (Em), Em/Am, peak early diastolic SR (Sre) were reduced, E/Em (the ratio of the peak transmitral flow velocity during early diastole (E) to the peak annular velocity during early diastole (Em) obtained by TDI) were increased in patients with TOF compared to the control group; The Time from onset of QRS to Sm (Q-Sm) and the ejection time of RV were reduced and myocardial relaxation time was longer. TDI showed that RV E/Em significantly correlated with RV end diastolic pressure (RVDP), however, the RV conventional echocardiographic parameters did not correlate with any invasive measure of RV function. Six months to one year after surgically repaired TOF, the index of systolic and diastolic function of LV were declined to normal, but the index of systolic and diastolic function of RV were not improved in the TOF6 group.
2. There was no correlation of NT-proBNP to age and gender. Levels of NT-proBNP were elevated in the patients with TOF before and early after operation than control group. Howere, there was no significant difference between before and early after operation in TOF. Plasma NT-proBNP levels correlated significantly with LVAm obtained by TDI, SRs andεin the mid segments of free wall of RV obtained by strain rate and strain analysis and significantly correlated with central vena press(CVP) just after operation, but no correlated with the pressure of any cavity and EF of RV.
3. IOD of mmp-2 of myocardium was significantly correlated IOD of mmp-9 of myocardium. IOD of mmp-9 or mmp-2 of myocardium was significantly negative correlated with Simpson's biplane RVEF and SRs in the mid segments of free wall of RV; postive correlated with the age of the patient and CVP just after operation. Level of plasma mmp9 was increased in TOF group than control group and significantly correlated with level of plasma NT-proBNP and LogNT-proBNP.
Conclusion:
Our group recently demonstrated that TDI variables, SR and Strain analysis derived from TDI data has the potential to assess RV function, appeared to be more sensitive indicators of RV myocardial dysfunction than conventional indices of RV function.RV dysfunction detected by TDI variables, SR and Strain analysis determination in asymptomatic or minimally symptomatic TOF patients correlated well with plasma NT-proBNP and IOD of mmp9. Thus, these simple non-invasive methods can be used additionally to help in assessing RV function in TOF with impaired cardiac function before they become clinically symptomatic. The increasing of MMPs expression in the plasma and myocardia have a relation to the structure and function of right ventricular remodeling in TOF.
引文
[1]Marcu CB, Beek AM, Van Rossum AC. Cardiovascular magnetic resonance imaging for the assessment of right heart involvement in cardiac and pulmonary disease. Heart Lung Circ,2006,15(6):362-370.
[2]Atik F A, Atik E, da-Cunha C R, et al. Long-term results of correction of tetralogy of Fallot in adulthood[J]. Eur J Cardiothorac Surg,2004,25(2):250-255.
[3]郭颖,周爱卿,李奋,等.法乐氏四联症根治术后运动功能和运动风险的研究.中华心血管病杂志,2003,31(9)：673-677.
[4]余国膺.右心衰竭的细胞和分子机制——美国心肺血研究所执行总结.中国心脏起博与心电生理杂志,2007,21：379.
[5]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17(7):788-802.
[6]Yap L, Mukerjee D, Timms P,et al. Natriuretic peptides, respiratory disease and the right heart. Chest,2004,126(4):1330-1336.
[7]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunetion. Heart,2001,86(1):27-30.
[8]Ali Dodge-Khatami, Emanuela Valsangiacomo Buchel, Walter Knirsch, et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation. Ann Thorac Surg,2006,82(3):983-988.
[9]Trim JE, Samra SK, Arthur MJ, et al. Upstream tissue inhibitors of metalloproteinase-1 (TIMP-1) element-1, a novel and essential regulatory DNA motif in the human TIMP-1 gene promoter, directly interacts with a 30-kDa nuclear protein[J]. J Biol Chem,2000,275(9):6657-6653.
[10]常泰吉,朱鸿良,薛慈,等.小儿先天性心脏病.安徽科学技木出版社,1982：128-129.
[11]张南滨,汪曹炜,张仁福,等.核素心室显像对法洛四联症矫正术前后心室功能的评价.中华核医学杂志,1996,16(4)：215-216.
[12]石艳芬,梁平,宁寿葆,等.多巴酚丁胺负荷超声心动图检测法乐四联症患儿左心室收缩功能.中华儿科杂志,1997,35(1)：7-10.
[13]Carlsson M, Ugander M, Heiberg E, et al. The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans. Am J Physiol Heart Circ Physiol,2007,293(1):H636-644.
[14]李玉曼,谢明星,吕清,等.超声二维应变成像与组织多普勒技术评价右心室纵向收缩功能的对比研究.中华超声影像学杂志,2009,18(5)：397-400.
[15]Hiarada K, Orino T, Yasuoka K, et al. Tissue Doppler imaging of left and right ventricles in normal children. Tohoku J Exp Med,2000,191(1):21-29.
[16]Kapusta L, Thijssen JM, Cuypers MH, et al. Assessment of myocardial velocities in healthy children using tissue Doppler imaging. Ultrasound Med Biol,2000, 26(2):229-237.
[17]Weidemann F, Jamall F, Sutherland GR, et al. Myocardial function defined by strain rate and strain during alterations in no tropic states and heart rate[J]. Am J Physiol Heart Circ Physiol,2002,238(2):h792-799.
[18]Weidemann F, Eyskens B, Jamal F, et al:Quantification of regional left and right ventricular radial and longitudinal function in healthy children using ultrasound-based strain rate and strain imaging. J Am Soc Echocardiogr,2002,15(1):20-28.
[19]侯海军,智光,张晓娟,等.速度向量成像评价正常成人右心室应变和应变率.中华超声影像学杂志,2008,17(4)：281-283.
[20]Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance:a simpie and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy[J]. J Cardiol,1995,26(6): 357-366.
[21]Roberson DA, Cui W. Right ventricular Tei index in children:effect of method, age, body surface area,and heart rate. J Am Soc Echocardiogr,2007,20(6): 764-770.
[22]Schwerzmann M, Samman AM, Salehian O, et al. Comparison of echocardiographic and cardiac magnetic resonance imaging for assessing right ventricular function in adults with repaired tetralogy of fallot. Am J Cardiol,2007, 99(11):1593-1597.
[23]谢明星,王静,王新房,等.定量组织速度成像技术评价正常成人右心室局域心肌功能.中华超声影像学杂志,2006,15：168-170.
[24]Anderson NH, Poulsen SH. Evaluation of the longitudinal contraction of the left ventricle in normal subjects by Doppler tissue tracking and strain rate. J Am Soc Echocardiogr,2003,16(7):716-723.
[25]孟祥春,孙锟,张玉奇,等.超声应变率显像估测犬的右心室长轴收缩功能.中国超声医学杂志,2005,21(5)：321-324.
[26]Eyskens B, Weidemann F, Kowalski M, et al. Regional right and left ventricular function after the Senning operation:an ultrasonic study of strain rate and strain. Cardiol Young,2004,14(3):255-264.
[27]Sanchez-Quintana D, Anderson RH, Ho SY. Ventricular myoarchitecture in tetralogy of Fallot. Heart,1996,76(3):280-286.
[28]Dokainish H, Zoghbi WA, Lakkis NM, et al. Optimal noninvasive assessment of left ventricular filling pressures:a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters. Circulation,2004,109(20):2432-9.
[29]Nageh MF, Kopelen HA, Zoghbi WA, et al. Estimation of mean right atrial pressure using tissue Doppler imaging. Am J Cardiol,1999,84(12):1448-1451.
[30]朱鲜阳,钱武阳,张玉戚,等.轴位心血管造影对法洛四联症右心功能的评价. 中国循环杂志,1991,6：7.
[31]马沛然,庄建新,曲声赞,等.法洛四联症的左心功能及影响因素.山东医科大学学报,1993,31：51.
[32]de Lorgeril M, Friedli B, Assimacopoulos A. Factors affecting left ventricular function after correction of tetralogy of Fallot. Br Heart J,1984,52(5),536-541.
[33]陈欣欣,张镜方,陈伟达,等.小儿法乐四联征根治术术前术后左室容积及收缩功能的变化.广东医学,1997,18(4)：224-225.
[34]张志樑,朱洪生,冯卓荣,等.法乐四联症矫正术前后左心室容积及收缩功能.中华胸心血管外科杂志,1993,9(4)：292-293.
[35]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17(7):788-802.
[36]Pellerin D, Sharma R, Elliott P, et al. Tissue Doppler,strain,and strain rate echocardiography for the assessment of left and right systolic ventricular function. Heart,2003,89 Suppl 3:iii9-17.
[37]Abd El Rahman MY, Hui W, Timme J, et al. Analysis of atrial and ventricular performance by tissue Doppler imaging in patients with atrial septal defects before and after surgical and catheter closure. Echocardiography,2005,22(7):579-585.
[1]Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature,1988,3,332:78-81.
[2]Vanderheyden M, Bartunek, Claeys G, et al. Head to head comparison of N·-terminal pro-B-type natriurctic peptide and B-type natriurctic peptide in patients with/without left ventricular systolic dysfunction.Clin Biochem,2006, 39(6):640-645.
[3]Yeo K'r, Wu AH, Apple FS, et al. Multicenter evaluation of the Roche NT-NP assay and comparison to the Biosite Triage BNP assay[J]. Clin Chim Acts,2003, 338:107-115.
[4]Clerico A, Emdin M. Diagnostic accurancy and prognostic relevance of the measurement of cardiac natriuretic peptides:Clin Chem,2004,50:33-50.
[5]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[6]Matsuo K, Nishikimi T, Yutani C, et al. Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia. Circulation, 1998,98:2433-40.
[7]Mir TS,Flato M,Falkenberg J,et al.Plasma concentrations of N-terminal brain natriuretic peptide in healthy children, adolescents,and young adults:effect of age and gender. Pediatr Cardiol,2006,27:73-77.
[8]Tulevski II, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunction. Heart,2001,86:27-30.
[9]Kambiz Norozi, Reiner Buchhorn, Christian Kaiser, et al. Plasma n-terminal pro-brain natriuretic peptide as a marker of right ventricular dysfunction in patients with tetralogy of fallot after surgical repair. Chest,2005,128:2563-2570.
[10]Dodge-Khatami A, Buchel EV, Knirsch W, et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation:Ann Thorac Surg,2006,82(3):983-988.
[11]Book WM, Hott BJ, McConnell M. B-type natriuretic peptide levels in adults with congenital heart disease and right ventricular failure. Am J Cardiol,2005,95: 545-546.
[12]Law YM, Keller BB, Feingold BM, et al. Usefulness of plasma B-type natriuretic peptide to identify ventricular dysfunction in pediatric and adult patients with congenital heart disease. Am J Cardiol,2005,95(4):474-478.
[13]Koch A, Zink S, Singer H. B-type natriuretic peptide in pediatric patients with congenital heart disease. Eur Heart J,2006,27(7):861-866.
[14]Andreas M.E. Koch, Stefan Zink, Helmut Singer. B-type natriuretic peptide in patients with systemic right ventricle.Cardiology,2008,110:1-7.
[15]Mir TS, Flato M, Falkenberg J, et al. Plasma concentrations of n-terminal brain natriuretic peptide in healthy children, adolescents,and young adults:effect of age and gender Pediatr Cardiol,2006,27:73-77.
[16]耿庆,高尚志.法乐氏四联症右室心肌碱性成纤维细胞生长因子的表达及意义.中华实验外科杂志,2001,18(4)：379.
[17]李虹,钱明阳,张智伟,等.184例小儿法乐氏四联症手术前后左室功能的超声研究.临床超声医学杂志,1995,6(2)：93-95.
[18]陈欣欣,张镜方,陈伟达,等.小儿法乐氏四联症根治术术前术后左室容积及收缩功能的变化.广东医学,1997,18(4)：224-225.
[19]张志樑,朱洪生,冯卓荣,等.法乐氏四联症矫正术前后左心室容积及收缩功 能.中华胸心外科杂志,1993,9(4)：292-293,313.
[20]陈玲,苏肇伉,丁文祥.法乐氏四联症根治术后远期效果.中华胸心血管外科杂志,1994,10(2)：109-111.
[21]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunction. Heart,2001,86:27-30.
[22]Thomas Oosterhof, Igor I. Tulevski, Hubert W. Vliegen, et al. Effects of volume and/or pressure overload secondary to congenital heart disease (Tetralogy of Fallot or pulmonary stenosis) on right ventricular function using cardiovascular magnetic resonance and B-Type natriuretic peptide levels. Am J Cardiol,2006,97:1051-1055.
[23]Ali Dodge-Khatami, EmanuelaValsangiacomo Biichel, Walter Knirsch,et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation. Ann Thorac Surg,2006,82:983-988.
[1]Jessup M, Brozena S. Heart failure is associated with structural alterations of myocardial tissue, known as myocardial remodeling[1]. Heart failure. N Engl J Med,2003,348:2007-18.
[2]李新民,汪曾炜,朱洪玉.法乐氏四联症心肌细胞病理改变与心功能的关系.中华胸心血管外科杂志,1993,9(3)：210-211.
[3]Fuster V, Danielson M A, Robb RA, et al. Quantitation of left ventricular mycardial fiber hypertrophy and interstitial tissue in human hearts with chronically increased volume and pressure overload. Circulation,1977,55:504
[4]李刚,王湘,季军,等.法乐四联症右室流出道心肌超微结构特点及其临床意义.中华实验外科杂志,2006,23(9)：1036-1037.
[5]Gatzoulis MA, Elliott JT, Guru V, et al. Right and left ventricular systolic function late after repair of tetralogy of Fallot. Am J Cardiol,2000;86(12):1352-7
[6]吴薇,冯相平,陈新山.基质金属蛋白酶与心血管疾病及其法医学意义[J].中国法医学杂志,2005,20(1)；37-40.
[7]Visse R, Nagase H. Matrixmetalloproteinases and tissue inhibitors of metalloproteinases:structure, function, and biochemistry[J]. Circ Res,2003,92: 827-839.
[8]李广生.心肌间质病理研究进展与心肌纤维化的诊断[J].中国实验诊学,2003,2(1)：8-11.
[9]Kahari VM, Saarialho Kere U. Matrix metalloproteinase in skin[J]. Exp Derrnatol, 1997,6(5):199-213.
[10]Ducharme A, Frantz S, Aikawa M, et al. Targeted deletion of matrix metalloprot einase-9 attenuated left ventricular enlargement and collagen accumulation after experimental myocardial infarction. J Clin Invest,2000,106:55-62.
[11]Mukheriee R, Brinsa TA, Dowdy KB, et al. Myocardial infarct expansion and matrix metalloproteinase inhibition. Circulation,2003,107:618-625.
[12]King MK, Coker ML, Goldberg A, et al. Selective matrix metalloproteinase inhibition with developing heart failure:effects on left ventricular function and structure. Circ Res,2003,92:177-185.
[13]Spinale FG. Myocardial matrix remodeling and the matrix metalloproteinases: influence on cardiac form and function, physiol. Rev,2007,87(4):1285-1342.
[14]Trim JE, Samra SK, Arthur MJ, et al. Upstream tissue inhibitors of metalloproteinase-1 (TIMP-1) element-1, a novel and essential regulatory DNA motif in the human TIMP-1 gene promoter, directly interacts with a 30-kDa nuclear protein[J]. J Biol Chem,2000,275(9):6657-6653.
[15]Cleutjens J P M. The role of matrix metalloproteinases in heart failure. Cardivas Res,1996,32:816-821.
[16]Soini Y, Satta J, Maattaa M. Expression of MMP2, MMp9, MT1-MMP, TIMP1 and TIMP2 mRNA in valvular lesions of the heart[J]. J Pathol,2001,194:225-231.
[17]Peterson JT, Hallak H, Johnson L, et al. Matrix metalloproteinase inhibition attenuates left ventricnlar remodeling and dysfunction in a rat model of progressive heart failure[J]. Circulation,2001,103:2303-2309.
[18]Chesler NC, Ku DN, Galis ZS. Transmural pressure induces matrix-degrading activity in porcine arteries ex vivo[J]. Am J P hysiol,1999,277(5):H2002-9.
[19]李自普,曹倩,邢泉生.法洛四联症病儿右心室结构和功能与基质金属蛋白酶的关系.青岛大学医学院学报,2006,42(3)：228-230.
[20]方风,马则敏,赵玉环,等.法乐氏四联症右室心肌收缩功能的检测.临床儿科杂志,1995,13(3)：159-160.
[21]陈恩,苏肇伉,丁文祥,等.法乐氏四联症心室超微结构的特征及其临床意义.上海第二医科大学学报,1997,17(1)：76-8.
[22]陈兵,王洪均,戴晓注,等.法乐氏四联症右室流出道肌肉形态计量学分析. 浙江医学,1995,17(5)：264-265.
[23]Bradshaw AD, Baicu CF, Rentz TJ, et al. Pressure overload-induced alterations in fibrillar collagen content and myocardial diastolic function:role of secreted protein acidic and rich in cysteine (SPARC) in post-synthetic procollagen processing. Circulation,2009,119(2):269-280.
[24]Calhoun P, Feldman PS, Armstrong P, et al. The clinical profile and surgical treatment of tetrology of Fallot in the aduIt:Results of repair in 200 patients. Ann Thorac Surg,1986,41(6):592-596.
[25]Babu-Narayan SV, Kilner PJ, li W, et al. Ventricular fibrosis suggested by cardiovascular magnetic resonance in adults with repaired tetralogy of Fallot and its relationship to adverse markers of clinical outcome. Circulation,2006,113: 405-413.
[26]Peterson JT, Hallak H, Johnson L, et al. Matrix metalloproteinase inhibition attenuates left ventricular remodeling and disfunction in a rat model of progressive heart failure. Circulation,2001,103(18):2303-2309.
[27]Lee RT. Matrix metalloproteinase inhibition and prevention of heart failure. Trends Cardiovasc Med,2001,11(5):202-205.
[28]Wang Junkui, Cui Changcong, Yao Qinghai, et al. Effects of AT1 antagonist on mmp2, mmp9 expression and collagen remodeling in left ventricle of rabbit undergoing chronic pressure overload. South China Journal of Cardiology,2003, 4(1):55-58,62.
[29]Schwartz SM, Gordon D, Mosca RS, et al. Collagen content in normal, pressure, and pressure-volume overloaded developing human hearts. Am J Cardiol, 1996,77(9):734-8.
[30]Squire IB, Evans J, Ng LL, et al. Plasma MMP-9 and MMP-2 following acute myocardial infarction in man:correlation with echocardiographic and neurohumoral parameters of left ventricular dysfunction. J Card Fail,2004,10: 328-33.
[31]Yamazaki T, Lee JD, Shimizu H, et al. Circulating matrix metalloproteinase-2 is elevated in patients with congestive heart failure. Eur J Heart Fail,2004,6:41-5,3.
[32]Tziakas DN, Chalikias GK, Hatzinikolaou EI, et al. N-terminal pro-B-type natriuretic peptide and matrix metalloproteinases in early and late left ventricular remodeling after acute myocardial infarction. Am J Cardiol,2005,96:31-4.
[33]Taketoshi Yamazaki, Jong-Dae Lee, Hiromasa Shimizu, et al. Circulating matrix metalloproteinase-2 is elevated in patients with congestive heart failure. The European Journal of Heart Failure,2004,(6):41-45.
[34]张南滨,汪曾炜,张仁福,等.核素心室显像对法洛四联症矫正术前后心室功能的评价.中华核医学杂志,1996,16(4)：215-216.
[1]Marcu CB, Beek AM, Van Rossum AC. Cardiovascular magnetic resonance imaging for the assessment of right heart involvement in cardiac and pulmonary disease. Heart Lung Circ,2006,15:362-370.
[2]Baker BJ, Wilen MM, Boyd CM, et al. Relation of right ventricular ejection fraction to exercise capacity in chronic left ventricular failure. Am J Cardiol,1984, 54:596-9.
[3]Mendes LA, Dec GW, Picard MH, et al. Right ventricular dysfunction:an independent predictor of adverse outcome in patients with myocarditis. Am Heart J,1994,128:301-7.
[4]Ghio S, Gavazzi A, Campana C, et al.Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol,2001,37:183-8.
[5]Fogel MA, Rychik J.Right ventricular function in congenital heart disease: pressure and volume overlode lesion. Prog Cardiovasc Dis,1998,40:343-356.
[6]Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmias and sudden death in repaired tetralogy of Fallot; a multi-centre study. Lancet,2000, 356:975-981.
[7]Foale R, Nihoyannopoulos P, McKenna W, et al. Echocardiographic measurement of the normal adult right ventricle. Br Heart J,1986,56:33-44.
[8]Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, et al. Echocardiography Doppler in pulmonary embolism:right ventricular dysfunction as a predictor of mortality rate. Am Heart J,1997,134:479-87.
[9]Gomez A, Bialostozky D, Zajarias A, et al. Right ventricular ischemia in patients with primary pulmonary hypertension. J Am Coll Cardiol,2001,38:1137-42.
[10]Sanchez-Guintana D, Anderson RH, Ho SY. Ventricular myoarchitecture in tetralogy of Fallot. Heart,1996,76:280-6.
[11]Ghio S, Gavazzi A, Campana C, et al. Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol,2001,37:183-8.
[12]Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol, 1990,66:493-6.
[13]Therrien J, Provost Y, Merchant N, et al. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol,2005,95:779-82.
[14]初洪钢,孙彬.多普勒参数评价高血压病右心室功能的应用[J].中华医学杂志,2004,28：221-224,
[15]张玉奇,陈树宝,孙锟,等.改良肺动脉／主动脉血流时间间期比定量估测肺动脉压的研究.中华超声影像学杂志,2000,9(1)：32-34.
[16]Gill EA. Live three-dimensional echo-a major incremental step in the development of cardiac ultrasound[J]. J Cardiovasc Manag,2003,14(2):13-17.
[17]Schindera ST, Mehwald PS, Jones M, et al. Accuracy of real-time dimensional echocardiography for quantitative right ventricular volume:static and pulastile flow studies in an anatomic in vitro model[J]. J Ultrasound Med,2002,12: 109-111.
[18]Ota T, Fleishman CE, Strn b M, et al. Real time three dimensional echocardiography:feasibility of dynamic right ventricular volume measurement with saline contrast[J]. Am Heart,1999,137(5):958-966.
[19]朱卫华,黄先玫.先天性心脏病肺动脉高压手术前后右心功能变化和治疗.临床儿科杂志,2004,22(3)：143-146.
[20]Pellerin D, Sharma R, Elliott P, Veyrat C. Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventri-cular function. Heart,2003,89(Suppl.3):iii9-17.
[21]Lind B, Nowak J, Dorph J, et al. Analysis of temporal requirements for myocardial tissue velocity imaging. Eur J Echocardiogr,2002,3:214-9.
[22]Ueti OM, Camargo EE, Ueti Ade A,et al. Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography[J]. Heart,2002,88(3):244-248.
[23]Meluzi'n J, Spinarova'L, Bakala J, et al. Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid and non-invasive method of evaluating right ventricular systolic function. Eur Heart J,2001,22: 340-348.
[24]D'Andrea A, Caso P, Galderisi M, et al. Ventricular interdependence in patients with dual-chamber pacing:a Doppler tissue imaging study[J]. Echocardiography, 2002,19(4):289-297.
[25]Yilmaz M, Erol MK, Acikel M, et al. Pulsed Doppler tissue imaging can help to identify patients with right ventricular infarction[J]. Heart Vessels,2003, 18(3):112-116.
[26]Harada K, Toyono M, Yamamoto F.Assessment of right ventricular function during exercise with quantitative Doppler tissue imaging in children late after repair of Tetralogy of Fallot[J]. J Am Soc Echocardiogr,2004,17(8):863-869.
[27]Apostolopoulou SC, Laskari CV, Tsoutsinos A, et al. Doppler tissue imaging evaluation of right ventricular function at rest and during dobutamine infusion in patients after repair of tetralogy of Fallot. Int J Cardiovasc Imaging,2007,23(1): 25-31.
[28]Yalcin F, Kaftan A, Muderrisoglu H, et al. Is Doppler tissue velocity during early left ventricular filling preload independent? Heart,2002,87:336-9.
[29]Michael Vogel, Michael R. Schmidt, Steen B. Kristiansen, et al. Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility.Comparison with ventricular pressure-volume relations in an animal model. Circulation,2002,105; 1693-1699.
[30]Lytrivi ID, Lai WW, Ko HH, et al. Color Doppler tissue imaging for evaluation of right ventricular systolic function in patients with congenital heart disease. J Am Soc Echocardiogr,2005,18:1099-1104.
[31]葛建军,周汝元,史学功,等.法乐氏四联症根治术后心功能的临床评价.中华医学杂志,2006,86(6)：407-410.
[32]Toyono M, Harada K, Tamura M, et al. Myocardial acceleration during isovolumic contraction as a new index of right ventricular contractile function and its relation to pulmonary regurgitation in patients after repair of tetralogy of Fallot. J Am Soc Echocardiogr,2004,17(2):332-337.
[33]S.R. Ommen, R.A. Nishimura, C.P. Appleton. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures. A comparative simultaneous Doppler-catheterization study. Circulation,2000,102:1788-1794.
[34]Ueti OM, Camargo, E E, et al. Assessment of right ventricular function with Doppler echocardiographic indices derived from in cuspid annular motion: comparison with radionuclide angiography[J]. Heart,2002,88(3):244-248.
[35]Aoki M, Harada K, Ogawa M, et al. Quantitative assessment of Right Ventricular function using doppler tissue imaging in fetuses with and without heart failure[J]. Am Soc Echocardiogr,2004,17(1):28-35.
[36]Jun Oyamada, Manatomo Toyono, Shunsuke Shimada, et al. Noninvasive estimation of left ventricular end-diastolic pressure using tissue Doppler imaging combined with pulsed-wave Doppler echocardiography in patients with ventricular septal defects:a comparison with the plasma levels of the B-Type natriuretic peptide.Echocardiography,2008,25:270-277.
[37]Urheim S, Edvardsen T, Torp H, et al. Myocardial Strain by Doppler Echocardiography Validation of a New Method to Quantify Regional Myocardial Function. Circulation,2000,102(10):1158-1164.
[38]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17:788-802.
[39]Weidemann F, Jamall F, Sutherland GR, et al. Myocardial function defined by strain rate and strain during alterations in no tropic states and heart rate[J]. Am J Physiol Heart Circ Physiol,2002,238:792.
[40]Belohlavek M, Bartleson VB, Zobitz ME.Real-time srtain rate imaging validation of peak compression and expansion rate by a tissue-mimicking phantom[J]. Echocardiography,2001,18(7):565-57.
[41]舒先红,潘翠珍,黄国倩,等.致心律失常右心窒发育不良的心肌应变和应变率成像特征[J].中华超声影像学杂志,2004,13(6)：405-407.
[42]Weidemann F, Eyskens B, Jamal F, et al:Quantification of regional left and right ventricular radial and longitudinal function in healthy children using ultrasound-based strain rate and strain imaging. J Am Soc Echocardiogr,2002,15:20-28.
[43]孟祥春,孙锟,张玉奇,等.超声应变率显像技术估测犬的右心室长轴收缩功能.中国超声医学杂志,2005,21(5)：321-324.
[44]Weidemann F, Eyskens B, Sutherland GR.New ultrasound methods to quantify regional myocardial function in children with heart disease[J]. Pediatr cardiol, 2002,23(3):292-306.
[45]Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot. Am J Cardiol,2002,90:133-138.
[46]Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot. Am J Cardiol,2002,90(2):133-8.
[47]Eyskens B, Weidemann F, Kowalski M, et al. Regional right and left ventricular function after the Senning operation:An ultrasonic study of strain rate and strain. Cardiol Young,2004(3),14:255-264.
[48]Helle-Valle T, Crosby J, Edvardsen T, et al. New noninvasive method for assessment of left ventricular rotation:speckle tracking echocardiography. Circulation,2005,112:3149-56.
[49]Pirat B, McCulloch ML, Zoghbi WA. Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol,2006,98:699-704.
[50]Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance:a simpie and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy[J]. J Cardiol,1995,26(6):357-366.
[51]Baumwart RD, Meurs KM, Bonagura JD, et al. Tei index of myocardial performance applied to the right ventricle in normal dogs[J]. J Vet Inter Med,2005, 19(6):828-832.
[52]Norozi K, guchhom R, AlpersV, et al. Relation of systemic ventricular function quantified by myocardial performance index (Tei) to cardiopulmonary exercise capacity in adults after Mustard procedure for transposition of the grcat arteries [J]. Am J Cardiol,2005,96(12):1721-1725.
[53]Takeuchi D, Nakanishi T, Tomirnatsu H, el al. Evaluation of right ventricular performance long after the atriat switch operation for transposition of the great arteries using the Doppler Tei index[J]. Pediatr Cardiol,2006,27(1):78-83.
[54]LaCorte JC, Cabreriza SE, Rabkin DG, et al. Correlation of the Tei index with invasive measurements of ventricular function in a porcine model[J]. J Am Soc Echocardiogr,2003,16:442-447.
[55]孙轶,许迪,陆凤翔,等.组织多普勒成像测量Tei指数评价右心功能不全.东南大学学报,2008,27(1)：17-19.
[56]刘珊珊,段云友贾化平.Tei指数评价三尖瓣关闭不全时右心功能改变及其意义.生物医学工程与临床,2007,11(4)：300-302.
[57]Karnati PK, El-Hajjar M, Torosoff M, et al. Myocardial performance index correlates with right ventricular ejection fraction measured by nuclear ventriculography. Echocardiography,2008,25(4):381-5.
[58]Benjamin W. Eidem, Patrick W. O'Leary, Chuwa Tei, et al. Usefulness of the Myocardial Performance Index for Assessing Right Ventricular Function in Congenital Heart Disease. Am J Cardiol,2000,86:654-658.
[59]Ishii M, Eto G, Tei C, Quantization of the global right ventricular function in children with normal heart and congenital heart disease:a right ventricular myocardial performance index. Pediatr Cardiol,2000,21(5):416-21.
[60]Norozi K, Buchhorn R, Bartmus D, et al. Elevated brain natriuretic peptide and reduced exercise capacity in adult patients operated on for tetralogy of fallot is due to biventricular dysfunction as determined by the myocardial performance index.Am J Cardiol,2006,97(9):1377-1382.
[61]Markus Schwerzmann, Ahmed M. Samman, Omid Salehian, et al. Comparison of Echocardiographic and Cardiac Magnetic Resonance Imaging for Assessing Right Ventricular Function in Adults With Repaired Tetralogy of Fallot. Am J Cardiol, 2007,99:1593-1597.
[62]Harada K, Tamura M, Toyono M, et al.Assessment of global left ventricular function by tissue Doppler imaging.American Journal of cardiology,2001,88(8): 927-932.
[63]Yasuoka, K. Harada, K. Toyono, M. et al. Tei index determined by tissue Doppler imaging in patients with pulmonary regurgitation after repair of tetralogy of Fallot. Pediatr Cardiol,2004,25(2):131-6.
[64]A.E. van den Bosch, F.J. Meijboom, J.S. McGhie, Enhanced visualisation of the right ventricle by contrast echocardiography in congenital heart disease. Eur J Echocardiography,2004,5:104-110.
[65]徐衍梅,关桂萍,李渝芬.声学定量技术对小儿法乐氏四联症根治术前后心功能的评价.岭南心血管病杂志,2003,9(6)：384-386.
[66]Pacileo G, Limongelli G, Verrengia M, et al.Impact of pulmonary regurgitation and age at surgical repair on textural and functional right ventricular myocardial properties in patients with tetralogy of Fallot. Ital Heart J,2005 Sep;6(9):745-50I.
[67]Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature,1988,332:78-81.
[68]Vanderheyden M, Bartunek, Claeys G, et al. Head to head comparison of N--terminal pro-B-type natriurctic peptide and B-type natriurctic peptide in patients with/without left ventricular systolic dysfunction. Clin Biochem,2006,39: 640-645.
[69]Yeo K'r, Wu AH, Apple FS, et al. Multicenter evaluation of the RocheNT-NP assay and comparison to the Biosite Triage BNP assay[J]. Clin Chim Acts,2003,338: 107-115.
[70]Remme WJ, Swedberg K. European society of cardiology:comprehensive guidelines for the diagnosis and treatment of chronic heart failure. Task force for the diagnosis an d treatment of chronic heart failure of the european society of cardiology. Eur J Heart Fail,2002,4(1):11-22.
[71]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[72]Matsuo K, Nishikimi T, Yutani C, et al. Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia. Circulation, 1998,98:24330-40.
[73]Mir TS, Flato M, Falkenberg J, et al. Plasma concentrations of N-terminal brain natriuretic peptide in healthy children, adolescents, and young adults:effect of age an d gender Pediatr Cardiol,2006,27:73-77.
[74]Kambiz Norozi, MD; Reiner Buchhorn, MD; Christian Kaiser; G, et, al. Plasma N-Terminal Pro-Brain Natriuretic Peptide as a Marker of Right Ventricular Dysfunction in Patients With Tetralogy of Fallot After Surgical Repair.Chest,2005, 128:2563-2570.
[75]Yap L, Mukerjee D, Timms P, Ashrafian H, Coghlan JG. Natriuretic peptides, respiratory disease and the right heart. Chest,2004,126:1330-1336.
[76]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunetion. Heart,2001,86:27-30.
[77]Cowley CG, Bradley JD, Shaddy RE. B-type natriuretie peptide levels in congenital heart disease. Pediatr Cardiol,2004,25:336-340.
[78]Oosterhof T, Tulevski Ⅱ, Vliegen HW,et al.Effects of Volume and/or Pressure Overload Secondary to Congenital Heart Disease (Tetralogy of Fallot or Pulmonary Stenosis) on Right Ventricular Function Using Cardiovascular Magnetic Resonance and B-Type Natriuretic Peptide Levels. Am J Cardiol, 2006,97(7):1051-5.
[79]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[80]Hopkins WE, Chen Z, Fukagawa NK, et al. Increased atrial and brain natriuretie peptides in adults with cyanotic congenital heart disease:enhanced understanding of the relationship between hypoxia and natriuretie pe ptide secretion. Circulation, 2004,109:2872-2877.
[81]Ali Dodge-Khatami, Emanuela Valsangiacomo Buchel, Walter Knirsch, et al. Brain Natriuretic Peptide and Magnetic Resonance Imaging in Tetralogy With Right Ventricular Dilatation. Ann Thorac Surg,2006,82:983-988.
[82]Oosterhof T, Tulevski Ⅱ, Vliegen HW, et al. Effects of volume and/or pressure overload secondary to congenital heart disease (tetralogy of fallot or pulmonary stenosis) on right ventrieular function using cardiovascular magnetic resonance and B-type natriuretic peptide levels. Am J Cardiol,2006,97:1051-1055.
[83]Shih CY, Sapru A, Oishi P, et al. Alterations in plasma B-type natriuretie peptide levels after repair of congenital heart defects:a potential perioperative marker.J Thorac Cardiovase Surg,2006,131:632-638.
[84]K. G. Blyth, B. A. Groenning, P. B. Mark, et al.NT-proBNP can be used to detect right ventricular systolic dysfunction in pulmonary hypertension. Eur Respir J, 2007,29:737-744.
[85]Elin RJ, Winter WE. Laboratory and clinical aspects of B-type natriuretic peptides. Arch Pathol Lab Med,2004,128:697-9.
[86]Cowie MR, Mendez GF. BNP and congestive heart failure[J]. Prog Cardiovasc Dis, 2002,44(4):293-321.
[87]Oudiz RJ, Barst RJ, Hansen JE, et al. Cardiopulmonary exercise testing and six-minute walk correlations in pulmonary arterial hypertension. Am J Cardiol, 2006,97:123-126.
[88]Provencher S, Sitbon O, Humbert M, et al. Long-term outcome with first-line bosentan therapy in idiopathic pulmonary arterial hypertension. Eur Heart J, 2006,27:589-595.
[89]D' Andrea A, Caso P, Sarubbi B, et al.Right ventricular myocardial dysfunction in adult patients late after repair of tetralogy of fallot. Int J Cardiol,2004,94(2-3): 213-20.
[2]Atik F A, Atik E, da-Cunha C R, et al. Long-term results of correction of tetralogy of Fallot in adulthood[J]. Eur J Cardiothorac Surg,2004,25(2):250-255.
[3]郭颖,周爱卿,李奋,等.法乐氏四联症根治术后运动功能和运动风险的研究.中华心血管病杂志,2003,31(9)：673-677.
[4]余国膺.右心衰竭的细胞和分子机制——美国心肺血研究所执行总结.中国心脏起博与心电生理杂志,2007,21：379.
[5]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17(7):788-802.
[6]Yap L, Mukerjee D, Timms P,et al. Natriuretic peptides, respiratory disease and the right heart. Chest,2004,126(4):1330-1336.
[7]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunetion. Heart,2001,86(1):27-30.
[8]Ali Dodge-Khatami, Emanuela Valsangiacomo Buchel, Walter Knirsch, et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation. Ann Thorac Surg,2006,82(3):983-988.
[9]Trim JE, Samra SK, Arthur MJ, et al. Upstream tissue inhibitors of metalloproteinase-1 (TIMP-1) element-1, a novel and essential regulatory DNA motif in the human TIMP-1 gene promoter, directly interacts with a 30-kDa nuclear protein[J]. J Biol Chem,2000,275(9):6657-6653.
[10]常泰吉,朱鸿良,薛慈,等.小儿先天性心脏病.安徽科学技木出版社,1982：128-129.
[11]张南滨,汪曹炜,张仁福,等.核素心室显像对法洛四联症矫正术前后心室功能的评价.中华核医学杂志,1996,16(4)：215-216.
[12]石艳芬,梁平,宁寿葆,等.多巴酚丁胺负荷超声心动图检测法乐四联症患儿左心室收缩功能.中华儿科杂志,1997,35(1)：7-10.
[13]Carlsson M, Ugander M, Heiberg E, et al. The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans. Am J Physiol Heart Circ Physiol,2007,293(1):H636-644.
[14]李玉曼,谢明星,吕清,等.超声二维应变成像与组织多普勒技术评价右心室纵向收缩功能的对比研究.中华超声影像学杂志,2009,18(5)：397-400.
[15]Hiarada K, Orino T, Yasuoka K, et al. Tissue Doppler imaging of left and right ventricles in normal children. Tohoku J Exp Med,2000,191(1):21-29.
[16]Kapusta L, Thijssen JM, Cuypers MH, et al. Assessment of myocardial velocities in healthy children using tissue Doppler imaging. Ultrasound Med Biol,2000, 26(2):229-237.
[17]Weidemann F, Jamall F, Sutherland GR, et al. Myocardial function defined by strain rate and strain during alterations in no tropic states and heart rate[J]. Am J Physiol Heart Circ Physiol,2002,238(2):h792-799.
[18]Weidemann F, Eyskens B, Jamal F, et al:Quantification of regional left and right ventricular radial and longitudinal function in healthy children using ultrasound-based strain rate and strain imaging. J Am Soc Echocardiogr,2002,15(1):20-28.
[19]侯海军,智光,张晓娟,等.速度向量成像评价正常成人右心室应变和应变率.中华超声影像学杂志,2008,17(4)：281-283.
[20]Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance:a simpie and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy[J]. J Cardiol,1995,26(6): 357-366.
[21]Roberson DA, Cui W. Right ventricular Tei index in children:effect of method, age, body surface area,and heart rate. J Am Soc Echocardiogr,2007,20(6): 764-770.
[22]Schwerzmann M, Samman AM, Salehian O, et al. Comparison of echocardiographic and cardiac magnetic resonance imaging for assessing right ventricular function in adults with repaired tetralogy of fallot. Am J Cardiol,2007, 99(11):1593-1597.
[23]谢明星,王静,王新房,等.定量组织速度成像技术评价正常成人右心室局域心肌功能.中华超声影像学杂志,2006,15：168-170.
[24]Anderson NH, Poulsen SH. Evaluation of the longitudinal contraction of the left ventricle in normal subjects by Doppler tissue tracking and strain rate. J Am Soc Echocardiogr,2003,16(7):716-723.
[25]孟祥春,孙锟,张玉奇,等.超声应变率显像估测犬的右心室长轴收缩功能.中国超声医学杂志,2005,21(5)：321-324.
[26]Eyskens B, Weidemann F, Kowalski M, et al. Regional right and left ventricular function after the Senning operation:an ultrasonic study of strain rate and strain. Cardiol Young,2004,14(3):255-264.
[27]Sanchez-Quintana D, Anderson RH, Ho SY. Ventricular myoarchitecture in tetralogy of Fallot. Heart,1996,76(3):280-286.
[28]Dokainish H, Zoghbi WA, Lakkis NM, et al. Optimal noninvasive assessment of left ventricular filling pressures:a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters. Circulation,2004,109(20):2432-9.
[29]Nageh MF, Kopelen HA, Zoghbi WA, et al. Estimation of mean right atrial pressure using tissue Doppler imaging. Am J Cardiol,1999,84(12):1448-1451.
[30]朱鲜阳,钱武阳,张玉戚,等.轴位心血管造影对法洛四联症右心功能的评价. 中国循环杂志,1991,6：7.
[31]马沛然,庄建新,曲声赞,等.法洛四联症的左心功能及影响因素.山东医科大学学报,1993,31：51.
[32]de Lorgeril M, Friedli B, Assimacopoulos A. Factors affecting left ventricular function after correction of tetralogy of Fallot. Br Heart J,1984,52(5),536-541.
[33]陈欣欣,张镜方,陈伟达,等.小儿法乐四联征根治术术前术后左室容积及收缩功能的变化.广东医学,1997,18(4)：224-225.
[34]张志樑,朱洪生,冯卓荣,等.法乐四联症矫正术前后左心室容积及收缩功能.中华胸心血管外科杂志,1993,9(4)：292-293.
[35]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17(7):788-802.
[36]Pellerin D, Sharma R, Elliott P, et al. Tissue Doppler,strain,and strain rate echocardiography for the assessment of left and right systolic ventricular function. Heart,2003,89 Suppl 3:iii9-17.
[37]Abd El Rahman MY, Hui W, Timme J, et al. Analysis of atrial and ventricular performance by tissue Doppler imaging in patients with atrial septal defects before and after surgical and catheter closure. Echocardiography,2005,22(7):579-585.
[1]Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature,1988,3,332:78-81.
[2]Vanderheyden M, Bartunek, Claeys G, et al. Head to head comparison of N·-terminal pro-B-type natriurctic peptide and B-type natriurctic peptide in patients with/without left ventricular systolic dysfunction.Clin Biochem,2006, 39(6):640-645.
[3]Yeo K'r, Wu AH, Apple FS, et al. Multicenter evaluation of the Roche NT-NP assay and comparison to the Biosite Triage BNP assay[J]. Clin Chim Acts,2003, 338:107-115.
[4]Clerico A, Emdin M. Diagnostic accurancy and prognostic relevance of the measurement of cardiac natriuretic peptides:Clin Chem,2004,50:33-50.
[5]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[6]Matsuo K, Nishikimi T, Yutani C, et al. Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia. Circulation, 1998,98:2433-40.
[7]Mir TS,Flato M,Falkenberg J,et al.Plasma concentrations of N-terminal brain natriuretic peptide in healthy children, adolescents,and young adults:effect of age and gender. Pediatr Cardiol,2006,27:73-77.
[8]Tulevski II, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunction. Heart,2001,86:27-30.
[9]Kambiz Norozi, Reiner Buchhorn, Christian Kaiser, et al. Plasma n-terminal pro-brain natriuretic peptide as a marker of right ventricular dysfunction in patients with tetralogy of fallot after surgical repair. Chest,2005,128:2563-2570.
[10]Dodge-Khatami A, Buchel EV, Knirsch W, et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation:Ann Thorac Surg,2006,82(3):983-988.
[11]Book WM, Hott BJ, McConnell M. B-type natriuretic peptide levels in adults with congenital heart disease and right ventricular failure. Am J Cardiol,2005,95: 545-546.
[12]Law YM, Keller BB, Feingold BM, et al. Usefulness of plasma B-type natriuretic peptide to identify ventricular dysfunction in pediatric and adult patients with congenital heart disease. Am J Cardiol,2005,95(4):474-478.
[13]Koch A, Zink S, Singer H. B-type natriuretic peptide in pediatric patients with congenital heart disease. Eur Heart J,2006,27(7):861-866.
[14]Andreas M.E. Koch, Stefan Zink, Helmut Singer. B-type natriuretic peptide in patients with systemic right ventricle.Cardiology,2008,110:1-7.
[15]Mir TS, Flato M, Falkenberg J, et al. Plasma concentrations of n-terminal brain natriuretic peptide in healthy children, adolescents,and young adults:effect of age and gender Pediatr Cardiol,2006,27:73-77.
[16]耿庆,高尚志.法乐氏四联症右室心肌碱性成纤维细胞生长因子的表达及意义.中华实验外科杂志,2001,18(4)：379.
[17]李虹,钱明阳,张智伟,等.184例小儿法乐氏四联症手术前后左室功能的超声研究.临床超声医学杂志,1995,6(2)：93-95.
[18]陈欣欣,张镜方,陈伟达,等.小儿法乐氏四联症根治术术前术后左室容积及收缩功能的变化.广东医学,1997,18(4)：224-225.
[19]张志樑,朱洪生,冯卓荣,等.法乐氏四联症矫正术前后左心室容积及收缩功 能.中华胸心外科杂志,1993,9(4)：292-293,313.
[20]陈玲,苏肇伉,丁文祥.法乐氏四联症根治术后远期效果.中华胸心血管外科杂志,1994,10(2)：109-111.
[21]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunction. Heart,2001,86:27-30.
[22]Thomas Oosterhof, Igor I. Tulevski, Hubert W. Vliegen, et al. Effects of volume and/or pressure overload secondary to congenital heart disease (Tetralogy of Fallot or pulmonary stenosis) on right ventricular function using cardiovascular magnetic resonance and B-Type natriuretic peptide levels. Am J Cardiol,2006,97:1051-1055.
[23]Ali Dodge-Khatami, EmanuelaValsangiacomo Biichel, Walter Knirsch,et al. Brain natriuretic peptide and magnetic resonance imaging in tetralogy with right ventricular dilatation. Ann Thorac Surg,2006,82:983-988.
[1]Jessup M, Brozena S. Heart failure is associated with structural alterations of myocardial tissue, known as myocardial remodeling[1]. Heart failure. N Engl J Med,2003,348:2007-18.
[2]李新民,汪曾炜,朱洪玉.法乐氏四联症心肌细胞病理改变与心功能的关系.中华胸心血管外科杂志,1993,9(3)：210-211.
[3]Fuster V, Danielson M A, Robb RA, et al. Quantitation of left ventricular mycardial fiber hypertrophy and interstitial tissue in human hearts with chronically increased volume and pressure overload. Circulation,1977,55:504
[4]李刚,王湘,季军,等.法乐四联症右室流出道心肌超微结构特点及其临床意义.中华实验外科杂志,2006,23(9)：1036-1037.
[5]Gatzoulis MA, Elliott JT, Guru V, et al. Right and left ventricular systolic function late after repair of tetralogy of Fallot. Am J Cardiol,2000;86(12):1352-7
[6]吴薇,冯相平,陈新山.基质金属蛋白酶与心血管疾病及其法医学意义[J].中国法医学杂志,2005,20(1)；37-40.
[7]Visse R, Nagase H. Matrixmetalloproteinases and tissue inhibitors of metalloproteinases:structure, function, and biochemistry[J]. Circ Res,2003,92: 827-839.
[8]李广生.心肌间质病理研究进展与心肌纤维化的诊断[J].中国实验诊学,2003,2(1)：8-11.
[9]Kahari VM, Saarialho Kere U. Matrix metalloproteinase in skin[J]. Exp Derrnatol, 1997,6(5):199-213.
[10]Ducharme A, Frantz S, Aikawa M, et al. Targeted deletion of matrix metalloprot einase-9 attenuated left ventricular enlargement and collagen accumulation after experimental myocardial infarction. J Clin Invest,2000,106:55-62.
[11]Mukheriee R, Brinsa TA, Dowdy KB, et al. Myocardial infarct expansion and matrix metalloproteinase inhibition. Circulation,2003,107:618-625.
[12]King MK, Coker ML, Goldberg A, et al. Selective matrix metalloproteinase inhibition with developing heart failure:effects on left ventricular function and structure. Circ Res,2003,92:177-185.
[13]Spinale FG. Myocardial matrix remodeling and the matrix metalloproteinases: influence on cardiac form and function, physiol. Rev,2007,87(4):1285-1342.
[14]Trim JE, Samra SK, Arthur MJ, et al. Upstream tissue inhibitors of metalloproteinase-1 (TIMP-1) element-1, a novel and essential regulatory DNA motif in the human TIMP-1 gene promoter, directly interacts with a 30-kDa nuclear protein[J]. J Biol Chem,2000,275(9):6657-6653.
[15]Cleutjens J P M. The role of matrix metalloproteinases in heart failure. Cardivas Res,1996,32:816-821.
[16]Soini Y, Satta J, Maattaa M. Expression of MMP2, MMp9, MT1-MMP, TIMP1 and TIMP2 mRNA in valvular lesions of the heart[J]. J Pathol,2001,194:225-231.
[17]Peterson JT, Hallak H, Johnson L, et al. Matrix metalloproteinase inhibition attenuates left ventricnlar remodeling and dysfunction in a rat model of progressive heart failure[J]. Circulation,2001,103:2303-2309.
[18]Chesler NC, Ku DN, Galis ZS. Transmural pressure induces matrix-degrading activity in porcine arteries ex vivo[J]. Am J P hysiol,1999,277(5):H2002-9.
[19]李自普,曹倩,邢泉生.法洛四联症病儿右心室结构和功能与基质金属蛋白酶的关系.青岛大学医学院学报,2006,42(3)：228-230.
[20]方风,马则敏,赵玉环,等.法乐氏四联症右室心肌收缩功能的检测.临床儿科杂志,1995,13(3)：159-160.
[21]陈恩,苏肇伉,丁文祥,等.法乐氏四联症心室超微结构的特征及其临床意义.上海第二医科大学学报,1997,17(1)：76-8.
[22]陈兵,王洪均,戴晓注,等.法乐氏四联症右室流出道肌肉形态计量学分析. 浙江医学,1995,17(5)：264-265.
[23]Bradshaw AD, Baicu CF, Rentz TJ, et al. Pressure overload-induced alterations in fibrillar collagen content and myocardial diastolic function:role of secreted protein acidic and rich in cysteine (SPARC) in post-synthetic procollagen processing. Circulation,2009,119(2):269-280.
[24]Calhoun P, Feldman PS, Armstrong P, et al. The clinical profile and surgical treatment of tetrology of Fallot in the aduIt:Results of repair in 200 patients. Ann Thorac Surg,1986,41(6):592-596.
[25]Babu-Narayan SV, Kilner PJ, li W, et al. Ventricular fibrosis suggested by cardiovascular magnetic resonance in adults with repaired tetralogy of Fallot and its relationship to adverse markers of clinical outcome. Circulation,2006,113: 405-413.
[26]Peterson JT, Hallak H, Johnson L, et al. Matrix metalloproteinase inhibition attenuates left ventricular remodeling and disfunction in a rat model of progressive heart failure. Circulation,2001,103(18):2303-2309.
[27]Lee RT. Matrix metalloproteinase inhibition and prevention of heart failure. Trends Cardiovasc Med,2001,11(5):202-205.
[28]Wang Junkui, Cui Changcong, Yao Qinghai, et al. Effects of AT1 antagonist on mmp2, mmp9 expression and collagen remodeling in left ventricle of rabbit undergoing chronic pressure overload. South China Journal of Cardiology,2003, 4(1):55-58,62.
[29]Schwartz SM, Gordon D, Mosca RS, et al. Collagen content in normal, pressure, and pressure-volume overloaded developing human hearts. Am J Cardiol, 1996,77(9):734-8.
[30]Squire IB, Evans J, Ng LL, et al. Plasma MMP-9 and MMP-2 following acute myocardial infarction in man:correlation with echocardiographic and neurohumoral parameters of left ventricular dysfunction. J Card Fail,2004,10: 328-33.
[31]Yamazaki T, Lee JD, Shimizu H, et al. Circulating matrix metalloproteinase-2 is elevated in patients with congestive heart failure. Eur J Heart Fail,2004,6:41-5,3.
[32]Tziakas DN, Chalikias GK, Hatzinikolaou EI, et al. N-terminal pro-B-type natriuretic peptide and matrix metalloproteinases in early and late left ventricular remodeling after acute myocardial infarction. Am J Cardiol,2005,96:31-4.
[33]Taketoshi Yamazaki, Jong-Dae Lee, Hiromasa Shimizu, et al. Circulating matrix metalloproteinase-2 is elevated in patients with congestive heart failure. The European Journal of Heart Failure,2004,(6):41-45.
[34]张南滨,汪曾炜,张仁福,等.核素心室显像对法洛四联症矫正术前后心室功能的评价.中华核医学杂志,1996,16(4)：215-216.
[1]Marcu CB, Beek AM, Van Rossum AC. Cardiovascular magnetic resonance imaging for the assessment of right heart involvement in cardiac and pulmonary disease. Heart Lung Circ,2006,15:362-370.
[2]Baker BJ, Wilen MM, Boyd CM, et al. Relation of right ventricular ejection fraction to exercise capacity in chronic left ventricular failure. Am J Cardiol,1984, 54:596-9.
[3]Mendes LA, Dec GW, Picard MH, et al. Right ventricular dysfunction:an independent predictor of adverse outcome in patients with myocarditis. Am Heart J,1994,128:301-7.
[4]Ghio S, Gavazzi A, Campana C, et al.Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol,2001,37:183-8.
[5]Fogel MA, Rychik J.Right ventricular function in congenital heart disease: pressure and volume overlode lesion. Prog Cardiovasc Dis,1998,40:343-356.
[6]Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmias and sudden death in repaired tetralogy of Fallot; a multi-centre study. Lancet,2000, 356:975-981.
[7]Foale R, Nihoyannopoulos P, McKenna W, et al. Echocardiographic measurement of the normal adult right ventricle. Br Heart J,1986,56:33-44.
[8]Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, et al. Echocardiography Doppler in pulmonary embolism:right ventricular dysfunction as a predictor of mortality rate. Am Heart J,1997,134:479-87.
[9]Gomez A, Bialostozky D, Zajarias A, et al. Right ventricular ischemia in patients with primary pulmonary hypertension. J Am Coll Cardiol,2001,38:1137-42.
[10]Sanchez-Guintana D, Anderson RH, Ho SY. Ventricular myoarchitecture in tetralogy of Fallot. Heart,1996,76:280-6.
[11]Ghio S, Gavazzi A, Campana C, et al. Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol,2001,37:183-8.
[12]Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol, 1990,66:493-6.
[13]Therrien J, Provost Y, Merchant N, et al. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol,2005,95:779-82.
[14]初洪钢,孙彬.多普勒参数评价高血压病右心室功能的应用[J].中华医学杂志,2004,28：221-224,
[15]张玉奇,陈树宝,孙锟,等.改良肺动脉／主动脉血流时间间期比定量估测肺动脉压的研究.中华超声影像学杂志,2000,9(1)：32-34.
[16]Gill EA. Live three-dimensional echo-a major incremental step in the development of cardiac ultrasound[J]. J Cardiovasc Manag,2003,14(2):13-17.
[17]Schindera ST, Mehwald PS, Jones M, et al. Accuracy of real-time dimensional echocardiography for quantitative right ventricular volume:static and pulastile flow studies in an anatomic in vitro model[J]. J Ultrasound Med,2002,12: 109-111.
[18]Ota T, Fleishman CE, Strn b M, et al. Real time three dimensional echocardiography:feasibility of dynamic right ventricular volume measurement with saline contrast[J]. Am Heart,1999,137(5):958-966.
[19]朱卫华,黄先玫.先天性心脏病肺动脉高压手术前后右心功能变化和治疗.临床儿科杂志,2004,22(3)：143-146.
[20]Pellerin D, Sharma R, Elliott P, Veyrat C. Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventri-cular function. Heart,2003,89(Suppl.3):iii9-17.
[21]Lind B, Nowak J, Dorph J, et al. Analysis of temporal requirements for myocardial tissue velocity imaging. Eur J Echocardiogr,2002,3:214-9.
[22]Ueti OM, Camargo EE, Ueti Ade A,et al. Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography[J]. Heart,2002,88(3):244-248.
[23]Meluzi'n J, Spinarova'L, Bakala J, et al. Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid and non-invasive method of evaluating right ventricular systolic function. Eur Heart J,2001,22: 340-348.
[24]D'Andrea A, Caso P, Galderisi M, et al. Ventricular interdependence in patients with dual-chamber pacing:a Doppler tissue imaging study[J]. Echocardiography, 2002,19(4):289-297.
[25]Yilmaz M, Erol MK, Acikel M, et al. Pulsed Doppler tissue imaging can help to identify patients with right ventricular infarction[J]. Heart Vessels,2003, 18(3):112-116.
[26]Harada K, Toyono M, Yamamoto F.Assessment of right ventricular function during exercise with quantitative Doppler tissue imaging in children late after repair of Tetralogy of Fallot[J]. J Am Soc Echocardiogr,2004,17(8):863-869.
[27]Apostolopoulou SC, Laskari CV, Tsoutsinos A, et al. Doppler tissue imaging evaluation of right ventricular function at rest and during dobutamine infusion in patients after repair of tetralogy of Fallot. Int J Cardiovasc Imaging,2007,23(1): 25-31.
[28]Yalcin F, Kaftan A, Muderrisoglu H, et al. Is Doppler tissue velocity during early left ventricular filling preload independent? Heart,2002,87:336-9.
[29]Michael Vogel, Michael R. Schmidt, Steen B. Kristiansen, et al. Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility.Comparison with ventricular pressure-volume relations in an animal model. Circulation,2002,105; 1693-1699.
[30]Lytrivi ID, Lai WW, Ko HH, et al. Color Doppler tissue imaging for evaluation of right ventricular systolic function in patients with congenital heart disease. J Am Soc Echocardiogr,2005,18:1099-1104.
[31]葛建军,周汝元,史学功,等.法乐氏四联症根治术后心功能的临床评价.中华医学杂志,2006,86(6)：407-410.
[32]Toyono M, Harada K, Tamura M, et al. Myocardial acceleration during isovolumic contraction as a new index of right ventricular contractile function and its relation to pulmonary regurgitation in patients after repair of tetralogy of Fallot. J Am Soc Echocardiogr,2004,17(2):332-337.
[33]S.R. Ommen, R.A. Nishimura, C.P. Appleton. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures. A comparative simultaneous Doppler-catheterization study. Circulation,2000,102:1788-1794.
[34]Ueti OM, Camargo, E E, et al. Assessment of right ventricular function with Doppler echocardiographic indices derived from in cuspid annular motion: comparison with radionuclide angiography[J]. Heart,2002,88(3):244-248.
[35]Aoki M, Harada K, Ogawa M, et al. Quantitative assessment of Right Ventricular function using doppler tissue imaging in fetuses with and without heart failure[J]. Am Soc Echocardiogr,2004,17(1):28-35.
[36]Jun Oyamada, Manatomo Toyono, Shunsuke Shimada, et al. Noninvasive estimation of left ventricular end-diastolic pressure using tissue Doppler imaging combined with pulsed-wave Doppler echocardiography in patients with ventricular septal defects:a comparison with the plasma levels of the B-Type natriuretic peptide.Echocardiography,2008,25:270-277.
[37]Urheim S, Edvardsen T, Torp H, et al. Myocardial Strain by Doppler Echocardiography Validation of a New Method to Quantify Regional Myocardial Function. Circulation,2000,102(10):1158-1164.
[38]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging:a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr,2004,17:788-802.
[39]Weidemann F, Jamall F, Sutherland GR, et al. Myocardial function defined by strain rate and strain during alterations in no tropic states and heart rate[J]. Am J Physiol Heart Circ Physiol,2002,238:792.
[40]Belohlavek M, Bartleson VB, Zobitz ME.Real-time srtain rate imaging validation of peak compression and expansion rate by a tissue-mimicking phantom[J]. Echocardiography,2001,18(7):565-57.
[41]舒先红,潘翠珍,黄国倩,等.致心律失常右心窒发育不良的心肌应变和应变率成像特征[J].中华超声影像学杂志,2004,13(6)：405-407.
[42]Weidemann F, Eyskens B, Jamal F, et al:Quantification of regional left and right ventricular radial and longitudinal function in healthy children using ultrasound-based strain rate and strain imaging. J Am Soc Echocardiogr,2002,15:20-28.
[43]孟祥春,孙锟,张玉奇,等.超声应变率显像技术估测犬的右心室长轴收缩功能.中国超声医学杂志,2005,21(5)：321-324.
[44]Weidemann F, Eyskens B, Sutherland GR.New ultrasound methods to quantify regional myocardial function in children with heart disease[J]. Pediatr cardiol, 2002,23(3):292-306.
[45]Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot. Am J Cardiol,2002,90:133-138.
[46]Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of Fallot. Am J Cardiol,2002,90(2):133-8.
[47]Eyskens B, Weidemann F, Kowalski M, et al. Regional right and left ventricular function after the Senning operation:An ultrasonic study of strain rate and strain. Cardiol Young,2004(3),14:255-264.
[48]Helle-Valle T, Crosby J, Edvardsen T, et al. New noninvasive method for assessment of left ventricular rotation:speckle tracking echocardiography. Circulation,2005,112:3149-56.
[49]Pirat B, McCulloch ML, Zoghbi WA. Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol,2006,98:699-704.
[50]Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance:a simpie and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy[J]. J Cardiol,1995,26(6):357-366.
[51]Baumwart RD, Meurs KM, Bonagura JD, et al. Tei index of myocardial performance applied to the right ventricle in normal dogs[J]. J Vet Inter Med,2005, 19(6):828-832.
[52]Norozi K, guchhom R, AlpersV, et al. Relation of systemic ventricular function quantified by myocardial performance index (Tei) to cardiopulmonary exercise capacity in adults after Mustard procedure for transposition of the grcat arteries [J]. Am J Cardiol,2005,96(12):1721-1725.
[53]Takeuchi D, Nakanishi T, Tomirnatsu H, el al. Evaluation of right ventricular performance long after the atriat switch operation for transposition of the great arteries using the Doppler Tei index[J]. Pediatr Cardiol,2006,27(1):78-83.
[54]LaCorte JC, Cabreriza SE, Rabkin DG, et al. Correlation of the Tei index with invasive measurements of ventricular function in a porcine model[J]. J Am Soc Echocardiogr,2003,16:442-447.
[55]孙轶,许迪,陆凤翔,等.组织多普勒成像测量Tei指数评价右心功能不全.东南大学学报,2008,27(1)：17-19.
[56]刘珊珊,段云友贾化平.Tei指数评价三尖瓣关闭不全时右心功能改变及其意义.生物医学工程与临床,2007,11(4)：300-302.
[57]Karnati PK, El-Hajjar M, Torosoff M, et al. Myocardial performance index correlates with right ventricular ejection fraction measured by nuclear ventriculography. Echocardiography,2008,25(4):381-5.
[58]Benjamin W. Eidem, Patrick W. O'Leary, Chuwa Tei, et al. Usefulness of the Myocardial Performance Index for Assessing Right Ventricular Function in Congenital Heart Disease. Am J Cardiol,2000,86:654-658.
[59]Ishii M, Eto G, Tei C, Quantization of the global right ventricular function in children with normal heart and congenital heart disease:a right ventricular myocardial performance index. Pediatr Cardiol,2000,21(5):416-21.
[60]Norozi K, Buchhorn R, Bartmus D, et al. Elevated brain natriuretic peptide and reduced exercise capacity in adult patients operated on for tetralogy of fallot is due to biventricular dysfunction as determined by the myocardial performance index.Am J Cardiol,2006,97(9):1377-1382.
[61]Markus Schwerzmann, Ahmed M. Samman, Omid Salehian, et al. Comparison of Echocardiographic and Cardiac Magnetic Resonance Imaging for Assessing Right Ventricular Function in Adults With Repaired Tetralogy of Fallot. Am J Cardiol, 2007,99:1593-1597.
[62]Harada K, Tamura M, Toyono M, et al.Assessment of global left ventricular function by tissue Doppler imaging.American Journal of cardiology,2001,88(8): 927-932.
[63]Yasuoka, K. Harada, K. Toyono, M. et al. Tei index determined by tissue Doppler imaging in patients with pulmonary regurgitation after repair of tetralogy of Fallot. Pediatr Cardiol,2004,25(2):131-6.
[64]A.E. van den Bosch, F.J. Meijboom, J.S. McGhie, Enhanced visualisation of the right ventricle by contrast echocardiography in congenital heart disease. Eur J Echocardiography,2004,5:104-110.
[65]徐衍梅,关桂萍,李渝芬.声学定量技术对小儿法乐氏四联症根治术前后心功能的评价.岭南心血管病杂志,2003,9(6)：384-386.
[66]Pacileo G, Limongelli G, Verrengia M, et al.Impact of pulmonary regurgitation and age at surgical repair on textural and functional right ventricular myocardial properties in patients with tetralogy of Fallot. Ital Heart J,2005 Sep;6(9):745-50I.
[67]Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature,1988,332:78-81.
[68]Vanderheyden M, Bartunek, Claeys G, et al. Head to head comparison of N--terminal pro-B-type natriurctic peptide and B-type natriurctic peptide in patients with/without left ventricular systolic dysfunction. Clin Biochem,2006,39: 640-645.
[69]Yeo K'r, Wu AH, Apple FS, et al. Multicenter evaluation of the RocheNT-NP assay and comparison to the Biosite Triage BNP assay[J]. Clin Chim Acts,2003,338: 107-115.
[70]Remme WJ, Swedberg K. European society of cardiology:comprehensive guidelines for the diagnosis and treatment of chronic heart failure. Task force for the diagnosis an d treatment of chronic heart failure of the european society of cardiology. Eur J Heart Fail,2002,4(1):11-22.
[71]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[72]Matsuo K, Nishikimi T, Yutani C, et al. Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia. Circulation, 1998,98:24330-40.
[73]Mir TS, Flato M, Falkenberg J, et al. Plasma concentrations of N-terminal brain natriuretic peptide in healthy children, adolescents, and young adults:effect of age an d gender Pediatr Cardiol,2006,27:73-77.
[74]Kambiz Norozi, MD; Reiner Buchhorn, MD; Christian Kaiser; G, et, al. Plasma N-Terminal Pro-Brain Natriuretic Peptide as a Marker of Right Ventricular Dysfunction in Patients With Tetralogy of Fallot After Surgical Repair.Chest,2005, 128:2563-2570.
[75]Yap L, Mukerjee D, Timms P, Ashrafian H, Coghlan JG. Natriuretic peptides, respiratory disease and the right heart. Chest,2004,126:1330-1336.
[76]Tulevski Ⅱ, Groenink M, van Der Wall EE, et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventrieular pressure overload: correlation between plasma neurohormones and right ventrieular dysfunetion. Heart,2001,86:27-30.
[77]Cowley CG, Bradley JD, Shaddy RE. B-type natriuretie peptide levels in congenital heart disease. Pediatr Cardiol,2004,25:336-340.
[78]Oosterhof T, Tulevski Ⅱ, Vliegen HW,et al.Effects of Volume and/or Pressure Overload Secondary to Congenital Heart Disease (Tetralogy of Fallot or Pulmonary Stenosis) on Right Ventricular Function Using Cardiovascular Magnetic Resonance and B-Type Natriuretic Peptide Levels. Am J Cardiol, 2006,97(7):1051-5.
[79]Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. JAm Coll Cardiol,1998,31:202-8.
[80]Hopkins WE, Chen Z, Fukagawa NK, et al. Increased atrial and brain natriuretie peptides in adults with cyanotic congenital heart disease:enhanced understanding of the relationship between hypoxia and natriuretie pe ptide secretion. Circulation, 2004,109:2872-2877.
[81]Ali Dodge-Khatami, Emanuela Valsangiacomo Buchel, Walter Knirsch, et al. Brain Natriuretic Peptide and Magnetic Resonance Imaging in Tetralogy With Right Ventricular Dilatation. Ann Thorac Surg,2006,82:983-988.
[82]Oosterhof T, Tulevski Ⅱ, Vliegen HW, et al. Effects of volume and/or pressure overload secondary to congenital heart disease (tetralogy of fallot or pulmonary stenosis) on right ventrieular function using cardiovascular magnetic resonance and B-type natriuretic peptide levels. Am J Cardiol,2006,97:1051-1055.
[83]Shih CY, Sapru A, Oishi P, et al. Alterations in plasma B-type natriuretie peptide levels after repair of congenital heart defects:a potential perioperative marker.J Thorac Cardiovase Surg,2006,131:632-638.
[84]K. G. Blyth, B. A. Groenning, P. B. Mark, et al.NT-proBNP can be used to detect right ventricular systolic dysfunction in pulmonary hypertension. Eur Respir J, 2007,29:737-744.
[85]Elin RJ, Winter WE. Laboratory and clinical aspects of B-type natriuretic peptides. Arch Pathol Lab Med,2004,128:697-9.
[86]Cowie MR, Mendez GF. BNP and congestive heart failure[J]. Prog Cardiovasc Dis, 2002,44(4):293-321.
[87]Oudiz RJ, Barst RJ, Hansen JE, et al. Cardiopulmonary exercise testing and six-minute walk correlations in pulmonary arterial hypertension. Am J Cardiol, 2006,97:123-126.
[88]Provencher S, Sitbon O, Humbert M, et al. Long-term outcome with first-line bosentan therapy in idiopathic pulmonary arterial hypertension. Eur Heart J, 2006,27:589-595.
[89]D' Andrea A, Caso P, Sarubbi B, et al.Right ventricular myocardial dysfunction in adult patients late after repair of tetralogy of fallot. Int J Cardiol,2004,94(2-3): 213-20.