由右心室区域规范化的TAPSE与肺部遵守,运动能力和临床结果的关系
Ran Tao1, Naga Dharmavaram2, Ahmed El Shaer1
1Department of Internal Medicine, School of Medicine and Public Health (R.T., A.E.S., S.H., M.G.-A.), University of Wisconsin-Madison.
Circulation. Heart failure
|May 6, 2024
概括
按右心室区域 (TAPSE/RVA) 索引的三环状平面缩外流更好地反映了肺高血压的严重程度,并比单独TAPSE更好地预测结果. 这些新型指标为肺高血压患者的右心功能提供了更好的预后价值.
科学领域:
- 心脏病学 心脏病学
- 肺高血压是什么意思 肺高血压
- 心声回声图 (Echocardiography) 是一种心声回声图.
背景情况:
- 三环状平面缩外流 (TAPSE) 主要测量右心室 (RV) 纵向运动.
- TAPSE不能完全捕捉RV形态或放射运动在肺高血压 (PH) 的变化.
- 需要新的心声回声指标来全面评估PH的RV功能.
研究的目的:
- 评估TAPSE按RV面积 (TAPSE/RVA) 索引的临床意义,用于评估PH.
- 将TAPSE/RVA的诊断和预后能力与标准TAPSE进行比较.
主要方法:
- 追溯分析71名NYHAII-III级呼吸障碍和疑似PH的患者.
- 以TAPSE,TAPSE/RVA-透心 (TAPSE/RVA-D) 和TAPSE/RVA-心 (TAPSE/RVA-S) 的计算进行心声学.
- 与侵入性血液动力学,运动能力 (峰值VO2),心脏MRI和生存分析的相关性.
主要成果:
- 与TAPSE相比,TAPSE/RVA指标与肺动脉合规性和VO2峰值的相关性更强.
- 与TAPSE相比,TAPSE/RVA-D和TAPSE/RVA-S在识别减少的肺动脉合规性和运动能力方面表现出更高的准确性.
- 与TAPSE不同的是,较低的TAPSE/RVA-D (<1.1) 和TAPSE/RVA-S (<1.5) 预测了12个月的不良心血管结果和住院治疗,而TAPSE.
结论:
- 按RV面积指数的TAPSE是评估PH中RV功能的更敏感的回声心脏学标志物.
- 与TAPSE相比,TAPSE/RVA指标与血液动力学和功能性参数提供了更好的相关性.
- 新的TAPSE/RVA指数作为怀疑PH的患者心血管不良事件的有价值预测.
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