通过右心室流出道收缩期偏移评估印度东部一家三级医院成人右心室功能的研究

Kapil Kant Tripathi, ANURAG JAIN, Vishal Shrivastava, Dileep Dandotiya
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引用次数: 0

摘要

研究目的研究目的如下:(1)通过 M 型超声心动图检查右心室流出道收缩期偏移评估右心室功能(RVF);(2)将右心室流出道收缩期偏移值与其他二维超声心动图评估右心室功能的方法相关联:本观察性前瞻性研究于 2021 年 8 月至 2022 年 8 月在加尔各答阿波罗多专科医院心内科门诊和住院部就诊的患者中进行,通过 M 型超声心动图以右室流出道收缩期偏移评估 RVF,并将结果与其他 RVF 评估方法(三尖瓣环平面收缩期偏移、组织多普勒成像、肺动脉压、分数面积变化 [FAC])相关联:两组患者中大多数年龄在 51-60 岁(45.5%),其次是 61-70 岁(29.5%)和 41-50 岁(20.5%)。与正常右心室功能障碍患者相比,右心室功能障碍患者的年龄更大。与对照组相比,右心室功能障碍患者的平均体重指数(BMI)明显更高,平均血红蛋白水平明显更低(P17 mm TAPSE):我们的研究得出结论,RVOT-SE 是诊断 RV 收缩功能减退患者的一种高度敏感且特异的方法。RVOT SE 作为唯一参数并不准确,但其高值可作为 RV 收缩功能正常的指标。其测量方法简单,只需从胸骨旁短轴切面进行一次简单且可重复的 M 模式测量即可。
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A STUDY ON ASSESSMENT OF RIGHT VENTRICULAR FUNCTION BY RIGHT VENTRICULAR OUTFLOW TRACT SYSTOLIC EXCURSION IN ADULT POPULATION ATTENDING A TERTIARY CARE HOSPITAL IN EASTERN INDIA
Objectives: The objectives of the study are as follows: (1) to assess the right ventricular function (RVF) by right ventricle outflow tract systolic excursion through M-mode echocardiography and (2) to correlate the right ventricle outflow tract systolic excursion value with other 2D echocardiographic methods of RVF assessment. Methods: The present observational prospective study was conducted in the department of cardiology, Apollo Multispeciality Hospital, Kolkata, among patients visiting the cardiology outpatient department and inpatient department from August 2021 to August 2022 to assess the RVF by right ventricle outflow tract systolic excursion through M-mode echocardiography and correlate the results with other methods (tricuspid annulus plane systolic excursion, tissue Doppler imaging, pulmonary artery pressure, fractional area change [FAC]) of RVF assessment. Results: Majority of the patients in both groups belong to the age group of 51–60 years (45.5%), followed by 61–70 years (29.5%) and 41–50 years (20.5%). Patients with right ventricular (RV) dysfunction were more aged as compared to normal RVF. The mean body mass index (BMI) was significantly higher and mean hemoglobin level was significantly lower in patients with RV dysfunction as compared to the control group (p<0.05). Both systolic and diastolic blood pressures were significantly higher among the patient group than in the control group (p<0.05). We found that right ventricular outflow tract systolic excursion (RVOT-SE), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler myocardial performance index, left ventricular (LV) ejection fraction (%), and FAC were significantly lower among patient group than control group (p<0.01). TAPSE ≤17 mm was the best cutoff value that differentiates patients with RV systolic dysfunction from healthy individuals with normal RV systolic function. There were 67% of patients with ≤17 mm and 33% had >17 mm TAPSE. Conclusion: Our study concludes that RVOT-SE is a highly sensitive and specific method for diagnosing reduced RV systolic function patients. RVOT SE is not accurate as a sole parameter, but its high values can be used as an indicator for normal RV systolic function. It is simple to get, requiring one easy and reproducible M-Mode measurement from the parasternal short-axis view.
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