儿童右心室功能障碍和双心室功能障碍的临床和心声学特征
Karla L Loss1, Andrew L Cheng2,3, Molly Weisert2,3
1Department of Pediatrics, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil.
Annals of pediatric cardiology
|February 23, 2026
概括
儿童右心室功能障碍经常被忽视. 与双心室功能障碍相比,孤立的RV功能障碍呈现出较轻微的症状和较少的不良结果,而双心室功能障碍具有较高的心血管风险.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管成像 - 心血管成像
- 儿科重症监护中心儿童重症监护中心
背景情况:
- 右心室 (RV) 缩功能障碍是儿童不常见的疾病,经常被诊断不足.
- 这项研究侧重于儿科患者RV功能障碍的临床和成像特征.
- 它将孤立的RV功能障碍与双心脏功能障碍 (BVD) 的特征进行比较.
研究的目的:
- 描述RV功能障碍在儿童群体中的临床和成像特征.
- 将孤立的RV功能障碍的特征与双心脏功能障碍的特征进行比较.
- 识别儿童严重RV功能障碍的回声心脏学预测因素.
主要方法:
- 回顾性分析心声学,心脏MRI和RV功能障碍的儿科患者的临床数据 (2015年1月至2022年3月).
- 通过心脏MRI定义为RV喷射率 (RVEF) <45%的RV功能障碍;严重的RV功能障碍定义为RVEF<35%.
- 患者根据左心室喷射分数<50%被归类为孤立的RV功能障碍或BVD.
主要成果:
- 其中包括65名儿童;49.2%患有孤立的VR功能障碍,50.8%患有BVD.
- 与BVD患者相比,孤立的VR功能障碍患者报告了较轻的症状 (NYHA I-II类:96.9%对57.6%).
- 在BVD患者中发生了不良心血管结局 (4/33),但在孤立的VR功能障碍患者中没有 (0/32).
- 断片面积变化 (FAC) <35%和声心图上的定性RV功能障碍的组合最好通过MRI预测严重的RV功能障碍.
结论:
- 与BVD患者相比,患有孤立RV功能障碍的儿科患者表现出较轻微的症状和较低的心血管不良结果的风险.
- 儿童双功能障碍与心血管不良事件的高风险有关.
- 将异常的FAC与心声回声学上的定性评估相结合,可以改善儿科患者严重RV功能障碍的预测.
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