|本期目录/Table of Contents|

[1]王俭,杨梦慧,孙灵跃,等.无创性压力-应变环评估肺动脉高压患者右心功能和预后的价值[J].国际心血管病杂志,2021,05:306-311.
 WANG Jian,YANG Menghui,SUN Lingyue,et al.Value of non-invasive pressure-strain loop for assessing right heart function and prognosis in patients with pulmonary arterial hypertension[J].International Journal of Cardiovascular Disease,2021,05:306-311.
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无创性压力-应变环评估肺动脉高压患者右心功能和预后的价值(PDF)

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2021年05期
页码:
306-311
栏目:
临床研究
出版日期:
2021-10-01

文章信息/Info

Title:
Value of non-invasive pressure-strain loop for assessing right heart function and prognosis in patients with pulmonary arterial hypertension
作者:
王俭;杨梦慧;孙灵跃;乔志卿;沈学东;沈节艳
200127 上海交通大学医学院附属仁济医院心内科
Author(s):
WANG Jian YANG Menghui SUN Lingyue QIAO Zhiqing SHEN Xuedong SHEN Jieyan
Department of Cardiology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
关键词:
肺动脉高压 无创性压力-应变环 心肌做功 右心功能 预后
Keywords:
Pulmonary arterial hypertension Non-invasive pressure-strain loop Myocardial work Right heart function Prognosis.
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2021.05.013
文献标识码:
-
摘要:
目的:探究无创性压力-应变环(PSL)技术用于评估肺动脉高压(PAH)患者右心功能和预后的价值。方法:2018年1月至2020年6月连续纳入52例PAH患者,完成常规经胸心脏彩超检查,使用PSL获得右心心肌做功参数,包括右室整体做功效率(RVGWE)、右室整体做功指数(RVGWI)、右室整体有用功(RVGCW)和右室整体无用功(RVGWW)。分析心肌做功参数与临床心功能评估参数的相关性。所有患者随访至2021年1月。分析心肌做功参数评估患者预后的价值。结果:相关性分析显示,心肌做功参数与临床心功能评估参数具有良好相关性(P<0.05)。所有患者随访395.0(266.5,415.8)d,COX多因素回归模型显示,RVGWE是患者临床预后的独立保护因素(HR=0.887,95%CI 0.794~0.992,P=0.035)。ROC曲线分析显示,RVGWE对于患者预后的预测价值最高(AUC=0.872, P<0.001),RVGWW次之(AUC=0.840, P<0.001)。生存分析显示,RVGWE≤81.5%或RVGWW≥177.0 mmHg%者(log-rank P<0.001)更易发生临床恶性事件。结论:PSL可以很好地评估PAH患者右心功能,心肌做功参数RVGWE和RVGWW是预测患者临床结局的有效指标。
Abstract:
Objective:To investigate the value of non-invasive pressure-strain loop(PSL)technique for assessing right heart function and prognosis in patients with pulmonary arterial hypertension(PAH).Methods:Fifty-two patients with PAH were enrolled consecutively fr

参考文献/References

[1] Galie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology(ESC)and the European Respiratory Society(ERS): endorsed by: Association for European Paediatric and Congenital Cardiology(AEPC), International Society for Heart and Lung Transplantation(ISHLT)[J]. Eur Respir J, 2015, 46(4):903-975.
[2] Bossone E, D’Andrea A, D’Alto M, et al. Echocardiography in pulmonary arterial hypertension: from diagnosis to prognosis[J]. J Am Soc Echocardiogr, 2013, 26(1):1-14.
[3] Fine NM, Chen L, Bastiansen PM, et al. Outcome prediction by quantitative right ventricular function assessment in 575 subjects evaluated for pulmonary hypertension[J]. Circ Cardiovasc Imaging, 2013, 6(5):711-721.
[4] Huang J, Yan ZN, Rui YF, et al. Left ventricular systolic function changes in primary hypertension patients detected by the strain of different myocardium layers[J]. Medicine(Baltimore), 2016, 95(2):e2440.
[5] Russell K, Eriksen M, Aaberge L, et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work[J]. Eur Heart J, 2012, 33(6):724-733.
[6] ATS Committee on Proficiency Standands for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test[J]. Am J Respir Crit Care Med, 2002, 166(1):111-117.
[7] Rubin LJ. Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines[J]. Chest, 2004, 126(1 Suppl):7S-10S.
[8] Mitchell C, Rahko PS, Blauwet LA, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography[J]. J Am Soc Echocardiogr, 2019, 32(1):1-64.
[9] Russell K, Eriksen M, Aaberge L, et al. Assessment of wasted myocardial work: a novel method to quantify energy loss due to uncoordinated left ventricular contractions[J]. Am J Physiol Heart Circ Physiol, 2013, 305(7):H996-H1003.
[10] 姬冰, 袁建军. 超声压力-应变环技术评估心肌做功研究进展[J]. 中国医学影像技术, 2020, 36(10):1579-1583.
[11] Chan J, Edwards NFA, Khandheria BK, et al. A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy[J]. Eur Heart J Cardiovasc Imaging, 2019, 20(1):31-39.
[12] Foris V, Kovacs G, Tscherner M, et al. Biomarkers in pulmonary hypertension: what do we know?[J]. Chest, 2013, 144(1):274-283.
[13] Urheim S, Rabben SI, Skulstad H, et al. Regional myocardial work by strain Doppler echocardiography and LV pressure: a new method for quantifying myocardial function[J]. Am J Physiol Heart Circ Physiol, 2005, 288(5): H2375-H2380.
[14] Butcher SC, Fortuni F, Montero-Cabezas JM, et al. Right ventricular myocardial work: proof-of-concept for non-invasive assessment of right ventricular function[J]. Eur Heart J Cardiovasc Imaging, 2021, 22(2):142-152.
[15] Warwick G, Thomas PS, Yates DH. Biomarkers in pulmonary hypertension[J]. Eur Respir J, 2008, 32(2): 503-512.
[16] Fritz JS, Blair C, Oudiz RJ, et al. Baseline and follow-up 6-min walk distance and brain natriuretic peptide predict 2-year mortality in pulmonary arterial hypertension[J]. Chest, 2013, 143(2):315-323.
[17] Forfia PR, Fisher MR, Mathai SC, et al. Tricuspid annular displacement predicts survival in pulmonary hypertension[J]. Am J Respir Crit Care Med, 2006, 174(9):1034-1041.
[18] Raymond RJ, Hinderliter AL, Willis PW, et al. Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension[J]. J Am Coll Cardiol, 2002, 39(7):1214-1219.
[19] Lu KJ, Chen JX, Profitis K, et al. Right ventricular global longitudinal strain is an independent predictor of right ventricular function: a multimodality study of cardiac magnetic resonance imaging, real time three-dimensional echocardiography and speckle tracking echocardiography[J]. Echocardiography, 2015, 32(6):966-974.
[20] Hubert A, Le Rolle V, Leclercq C, et al. Estimation of myocardial work from pressure-strain loops analysis: an experimental evaluation[J]. Eur Heart J Cardiovasc Imaging, 2018, 19(12):1372-1379.
[21] Walker LA, Buttrick PM. The right ventricle: biologic insights and response to disease[J]. Curr Cardiol Rev, 2009, 5(1):22-28.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81970047); 国家自然科学基金青年项目(81800048); 上海交通大学医学院附属仁济医院临床科研创新培育基金(PYII20-13)
通信作者:沈节艳,E-mail:shenjieyan@renji.com
更新日期/Last Update: 2021-10-01