论文部分内容阅读
Background Tissue Doppler imaging(TDI)has provided an objective means to quantify global and regional leftventricular(LV)and right ventricular(RV)function with improved accuracy and greater reproducibility than conventionalechocardiography.This study was conducted to assess RV myocardial systolic activation by TDI in subjects withpulmonary arterial hypertension(PAH).Methods A total of 30 patients with PAH and 30 healthy volunteers,all comparable in age and sex,underwent standardDoppler echo and TDI.Using pulsed Doppler echocardiography combined with TDI,the following regional parameterswere evaluated in three different myocardial segments(RV basal lateral wall,basal septal,and LV basal lateral)on apical4-chamber view:systolic(Sm),early-and late-diastolic(Em and Am)peak velocities.RV myocardial systolic activationdelay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basalseptal.In addition,RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change fromthe same apical 4-chamber view.Results Compared with the control group,patients with PAH showed increased RA and RV end-diastolic diameter(RA:(4.5±1.2)cm vs(3.0±0.8)cm,P<0.05 and RV:(4.8±1.9)cm vs(3.4±0.5)cm,P<0.05)and reduced RV fractional areachange;(35±14)% vs(56±9)%,P<0.05.These PAH patients showed lower myocardial peak velocities and a significantactivation delay compared with controls(P<0.05).Moreover,a strong correlation between RV myocardial systolicactivation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension(r=-0.82).Conclusions In PAH,RV myocardial systolic activation was markedly delayed,which was directly related to the RVfractional area change.RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predictRV dysfunction.Chin Med J 2007;120(13):1172-1175
Background Tissue Doppler imaging (TDI) has provided objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventionalechocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH). Methods A total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameterswere evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical4-chamber view: systolic (Sm), early- and late- diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal.In addition, RV end-diastolic and end-systolic area were compared to the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 ± 1.2) cm vs (3.0 ± 0.8 ), P <0.05 and RV: (4.8 ± 1.9) cm vs (3.4 ± 0.5) cm, P <0.05) and reduced RV fractional areachange; (35 ± 14)% vs (56 ± 9)%, P <0.05 .These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P <0.05) .Moreover, a strong correlation between RV myocardial systolicactivation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82 ). CONCLUSION In PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay evaluated by TDI could offer a unique approach to predict RV dysfunction. Chin Med J 2007; 120 (13) : 1172-1175