实时三维超声右心室容积曲线评价肺心病右心室收缩功能的价值

目的探讨实时三维超声右心室容积曲线评价肺心病患者右心室收缩功能的临床价值.材料和方法应用实时三维超声(RT-3DE)技术测量19例肺心病心功能代偿期(Ⅰ组)和16例心功能失代偿期(Ⅱ组)患者的右心室舒张末期容积(RVEDV)、收缩末期容积(RVESV)、每搏量(RVSV)及射血分数(RVEF).另选取20名健康成年人为对照组.结果肺心病Ⅰ组、Ⅱ组与对照组比较RVEDV增大,RVSV、RVEF减低(P＜0.01),且肺心病Ⅱ组差异更显著.随着心功能的降低,三维右心室容积曲线逐渐低平、收缩峰值后移.结论三维右心室容积曲线能够客观地反映肺心病代偿期与失代偿期右心室收缩功能的变化.     

M型、二维、实时三维超声心动图评价冠心病左室收缩功能的对比研究

目的:探讨M型超声心动图(MME)、二维超声心动图(2DE)、实时三维超声心动图(RT-3DE)在定量评价冠心病患者左室收缩功能(LVSF)的应用价值。方法:分别采用MME、2DE、RT-3DE测量34例冠心病患者左室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、每搏量(SV)和射血分数(EF),并在三种方法间进行比较。结果:MME和2DE两种方法测定的LVEDV、LVESV、SV大于RT-3DE测值,而EF小于RT-3DE测值,MME和2DE两种方法与RT-3DE各测值之间差异均有统计学意义(P0.05)。MME、2DE两种方法间差异无统计学意义(P0.05)。结论:RT-3DE能准确评价冠心病患者LVSF状况;MME和2DE高估LVEDV、LVESV、SV,低估EF。     

平行于三尖瓣短轴位与左心室短轴位在磁共振右心室容积测量中的比较研究

目的 比较平行于三尖瓣短轴位与左心室短轴位定位获得的右心室容积数据,评价前者的准确性和可重复性.方法 分别采用平行于三尖瓣短轴位与左心室短轴位定位方法获得30名健康志愿者的心脏连续层面磁共振电影图像,测量右心室收缩末期容积、舒张末期容积、搏出量、射血分数,并进行比较,同时比较两种方法下左心室及右心室搏出量,并评价观察者间和观察者内差异.结果 左心室短轴位与平行于三尖瓣短轴位定位方法所得右心室舒张末期容积[(117.4±23.8)ml,(125.6 ±25.2)ml]、收缩末期容积[(60.4±14.4) ml,(66.8±15.8)ml]、右心室搏出量[(57.1±12.7)ml,(58.8±12.8)ml]、右心室射血分数[(48.7±4.9)％,(46.9±4.8)％]均具有显著的统计学差异;除射血分数外,均以后者得到的容积更大.平行于三尖瓣短轴位定位方法所得右心室搏出量与左心室短轴位所得左心室搏出量无统计学差异,97％(29/30)数值位于一致性界限内.平行于三尖瓣短轴位定位方法所得右心室容积数据较左心室短轴位定位所得右心室容积数据具有更小的观察者间和观察者内差异,其偏差标准差和一致性界限更小.结论 两种定位方法计算得到的右心室容积具有显著的统计学差异,平行于三尖瓣短轴位定位方法的可重复性更好.     

实时三维超声心动图评价房颤患者右心功能的应用研究

目的探讨经胸实时三维超声心动图(RT-3DE)评价房颤患者右心功能的应用价值。方法对60例房颤患者(AF组)和50例门诊体检健康人群(对照组)均进行RT-3DE检查获得右心容积和功能相关参数。观察不同AF类型、AF术后复发组或窦性心律组右心容积和功能相关参数差异,分析其与AF术后复发的相关性。结果 AF组患者右心室最小容积(RVVmin)、右心室最大容积(RVVmax)高于对照组(P 0.05),收缩期至舒张末期三尖瓣环位移(TAPSE)、右心室射血分数(RVEF)、下腔静脉塌陷率(ΔIVC)低于对照组(P 0.05),持续性房颤(SAF)组右心室做功指数(MPI)高于阵发性房颤(PAF)组(P 0.05),TAPSE、ΔIVC低于PAF组(P 0.05)。AF复发组术后TAPSE、RVEF、ΔIVC低于窦性节律组(P 0.05),MPI高于窦性节律组(P 0.05)。结论经胸RT-3DE可定量评价AF患者右心结构和功能,对于病情评估、疗效判断均有一定价值。     

实时三维超声心动图评价尿毒症性心肌病左心室收缩功能及同步性

目的:探讨实时三维超声心动图(RT-3DE)评价尿毒症性心肌病(UM)患者左心室收缩功能及其同步性的应用价值。方法:①对30例尿毒症性心肌病患者和20例正常对照组采用RT-3DE采集其左心室容积和射血分数,同时应用二维超声心动图Si mpson法、M型Teichholz法进行检测,将三种方法所测的数据与磁共振显像技术所测的数据进行比较;②RT-3DE检查获取左心室全容积图像,应用QLAB4.2软件分析左心室17节段达到收缩期最小容积点时间(Tmsv)的标准差(Tmsv16-SD、Tmsv12-SD和Tmsv6-SD)及最大时间差(Tmsv16-Dif、Tmsv12-Dif和Tmsv6-Dif),对标准差及最大时间差行心率校正。结果:①UM组Teichholz法、Si mpson法所测LVEDV和LVESV均高于或低于RT-3DE测值,其差异均有统计学意义(P0.05);②正常组与UM患者16节段、12节段(中间段和基底段)和6节段(基底段)Tmsv的标准差和最大时间差值均有显著性差异,UM组均大于正常组(P0.05或P0.01)。结论:①在UM患者中,RT-3DE法的左室容积及射血分数数据准确性高;②RT-3DE为临床评价UM患者左心室收缩同步化及收缩功能提供了更加快速、简便、准确及无创性的新方法。     

实时三维超声心动图结合二维斑点追踪技术评价运动负荷前后对肥厚型非梗阻性心肌病患者右心室功能的影响

目的探讨应用实时三维超声心动图(RT-3DE)结合二维斑点追踪技术(2D-STI)评价运动前后肥厚型非梗阻性心肌病(HNCM)患者右心室功能。方法选取32例HNCM患者和与之性别、年龄相符的35例对照组。分别于运动前后测量右心室参数:三尖瓣舒张早、晚期血流峰值速度E峰、A峰(TV-E峰、TV-A峰);组织多普勒显像测得三尖瓣环收缩期峰值速度、舒张早期速度(TV-Sm、TV-Em);2D-STI方法测量右心室整体长轴应变(RVGLS);RT-3DE技术测得右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室每搏量(RVSV)、右心室射血分数(RVEF)以及三尖瓣环收缩期位移(TAPSE)、右心室面积变化率(RVFAC)。并将容积参数结合体表面积(BSA)进行标化得到右心室舒张末期容积指数(RVEDVi)、右心室收缩末期容积指数(RVESVi)、右心室每搏量指数(RVSVi)。结果运动后对照组与HNCM组常规参数TAPSE、RVFAC、TV-E峰、TV-A峰、三维参数RVEDVi、RVESVi、RVEF差异均无统计学意义(P>0.05);运动后对照组与HNCM组RV-Sm、RV-Em、RVGLS、RVSVi均增加,差异有统计学意义(P<0.05)。与对照组相比,静息期和运动后HNCM组常规参数TAPSE、RVFAC、TV-E峰、TV-A峰、三维参数RVEDVi、RVESVi、RVEF差异均无统计学意义(P>0.05);与对照组相比,静息期和运动后HNCM组RV-Sm、RV-Em、RVGLS、RVSVi均减低,差异有统计学意义(P<0.05);与对照组相比,HNCM组RVGLS变化率、RVEDVi变化率、RVSVi变化率均减低,差异有统计学意义(P<0.05)。结论HNCM患者存在右心室收缩和舒张功能障碍,运动后右心室储备功能减低,提示在HNCM患者中可能存在早期亚临床右心室心肌损伤,而这与运动能力密切相关。     

MRI对慢性高原病患者心脏结构和功能的评价研究

目的探讨心脏磁共振成像(CMRI)对慢性高原病(CMS)患者在心脏结构及功能方面的应用价值。方法选取分析30例CMS患者的CMRI影像学资料,另选取30例健康正常志愿者作为对照组。测定心脏结构参数:前室间隔厚度、左心室舒张末期内径、左心房内径、主动脉根部内径、主肺动脉内径、右心室流出道宽径、右心房横径、右心房长径、右心室横径、右心室长径;另测定左、右心室心功能参数:舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)和右心室心肌质量(RVMM),对两组参数进行对比分析。结果在心脏结构方面,CMS组前室间隔厚度、主肺动脉内径、右心室流出道宽径、右心房长径和右心室长径显著对照组(P 0.05);在左、右心功能方面,CMS组RVMM明显对照组(P 0.05),RVSV和RVEF明显对照组(P 0.05)。结论 CMRI可准确评价CMS患者心脏结构及功能,CMS患者以右心结构及功能改变为主。     

双源CT评价冠状动脉狭窄与左心室功能的临床应用价值

目的 探讨双源CT(dual-source computed tomography,DSCT) 冠状动脉造影评价冠状动脉狭窄程度与左心功能的相关性.方法 收集行DSCT冠状动脉造影检查冠心病患者87例及30例健康体检者,测量冠状动脉狭窄程度、左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)、心肌质量(MM),并与超声心动图(ECHO)、冠状动脉造影(CAG)作对照分析.结果 ①DSCT与CAG诊断冠状动脉狭窄无显著性差异(P>0.05).②DSCT和ECHO测量EDV、ESV、SV、EF相关性好,DSCT测得值稍大于ECHO,但各指标均无显著性差异(P＞0.05).③ESV、EF、SV 轻度狭窄组与重度狭窄组、中度狭窄与重度狭窄组间存在显著性差异(P<0.05),轻度狭窄组与中度狭窄组间无显著性差异(P>0.05);EDV、MM在轻度、中度、重度狭窄组间存在显著性差异(P<0.05);各指标在正常组和轻度狭窄组间无显著性差异(P>0.05).结论 DSCT冠状动脉造影一站式评估冠状动脉狭窄及心功能具有准确性高、可重复定量测量优势.根据冠状动脉狭窄程度可以初步评估心功能改变,当中度狭窄时,EDV、MM即出现显著改变,当重度狭窄时,各指标均出现显著改变,对心脏病变诊断、治疗监测等具有重要的临床应用价值.     

实时三维超声心动图与Sm、tei指数评价扩张型心肌病患者左室收缩功能的对比研究

目的:对比实时三维超声心动图(RT-3DE)与二尖瓣环收缩期峰速(Sm)、Tei指数(Tei index)对扩张型心肌病(DCM)患者左室收缩功能的评价,探讨RT-3DE在评价左室功能中的意义。方法:以健康体检者(28例)作为对照组,对临床及超声心动图确诊为DCM患者(33例)分别行2DE、RT-3DE及组织多普勒(TDI)扫查。结果:DCM患者左室舒张末容积(LVDV)、左室收缩末容积(LVSV)及Tei指数增大,左室射血分数(LVEF)、Sm明显减低,与对照组相比,差异均具有统计学意义(P<0.01)。在健康对照组中,RT-3DE、Tei指数、Sm与改良Simpson法有显著相关性(分别为r=0.895,P<0.01;r=0.637,P<0.05;r=-0.761,P<0.05);在DCM患者中,RT-3DE与改良Simpson有显著相关性(r=0.809,P<0.01),RT-3DE与Tei指数、Sm的相关性较对照组要明显减低(分别r=0.473,P<0.05;r=-0.484,P<0.05)。结论:RT-3DE较Sm、Tei指数更能有效评价DCM患者左室收缩功能,为临床提供更有价值的信息。     

实时三维超声心动图评估右心室功能:与MRI比较

目的:探讨实时三维超声心动图(RT3-DE)评估右心室功能的准确性。方法:34例临床疑似或确诊为肺动脉高压的患者一周内同时行实时三维超声心动图及MRI右心室功能检查,以MRI的检查结果为对照分析RT-3D所测得的右心室收缩末期容积(RVESV)、舒张末期容积(RVEDV)及射血分数(RVEF)值的准确性。结果:30例患者同时完成了RT3-DE和MRI检查,配对t检验结果表明两种检查的RVEF值差异无统计学意义(t=-0.14,P=0.89),但RVESV和RVEDV值差异有统计学意义(t=-4.97,P=0.00;t=-5.72,P=0.00)。结论:RT3-DE所测得的RVEF值准确、可靠,可用于右心室功能分析,但其所测得的RVESV和RVEDV值与MRI有一定差别,其准确性有待进一步提高。     

肺心病患者左右心功能的MRI研究

目的探讨MRI评价肺心病患者左、右心功能的应用价值。资料与方法前瞻性研究18例经肺功能实验、临床检查、X线、心电图、超声心动图等影像学检查证实为合并慢性阻塞性肺病(COPD)的肺心病患者,另选取18名健康志愿者作为对照组。采用1.5 T MRI仪测量两组左、右室心功能及右室心肌质量。采用独立样本t检验测量两组间差异是否有统计学意义。结果 2例肺心病患者MRI检查时由于屏气时间长、不能配合而排除。与对照组比较,16例肺心病患者右室(right ventricle,RV)舒张末期容积(end-diastolic volume,EDV)、右室收缩末期容积(end-systolic volume,ESV)及右室心肌质量(myocardial mass,MM)明显增加(P<0.05),而右室射血分数(ejec-tion fraction,EF)明显减低(P<0.01)。左室EDV及EF显著减低(P<0.01)。结论肺心病患者随着肺动脉压升高,超过右心室的代偿能力,促使右心室扩大和右心功能衰竭,同时左心功能损伤。MRI左右心功能的测量可以评价肺心病的严重程度,为临床提供治疗的客观依据。     

实时三维超声心动图和二维斑点追踪成像评价重度子痫前期左心房形态及功能

目的应用实时三维超声心动图(RT-3DE)和二维斑点追踪成像(2D-STI)评估重度子痫前期(SPE)患者的左心房形态及功能。资料与方法选取45例SPE患者作为SPE组,43例健康孕妇作为对照组。采用RT-3DE获取左心房容积参数最大、最小及收缩前容积(LAVmax、LAVmin及LAVpre);采用2D-STI获取左心房各时相应变:储器期(LASr)、管道期(LAScd)及泵期应变(LASct)。比较两组参数的差异,分析相关参数与左心房各时相应变之间的相关性。结果与对照组比较,SPE组LAVmax、LAVmin及LAVpre较高,LASr及LAScd较低,差异有统计学意义(P<0.05)。多因素回归分析显示,收缩压、左心室整体长轴应变为LASr(β=-0.313、0.359,P<0.01)和LAScd(β=-0.416、0.349,P<0.01)的独立预测因素。结论RT-3DE和2D-STI可定量评估SPE的左心房形态及功能。     

Evaluation of right ventricular function by 64-row CT in patients with chronic obstructive pulmonary disease and cor pulmonale

Purpose

The aim of this study was to investigate the clinical application value of right ventricle (RV) function measured by 64 multi-detector row CT (MDCT) in patients with chronic obstructive pulmonary disease (COPD) and cor pulmonale.

Materials and methods

Sixty-three consecutive patients with COPD and cor pulmonale were referred for electrocardiographically gated MDCT for evaluation of suspected or known coronary artery disease. Magnetic resonance imaging (MRI) for cardiac function analysis was performed on the same day. The MDCT and MRI examinations were successfully completed in 58 patients. Forty-six patients with COPD were divided into three groups according to the severity of disease by the pulmonary function test (PFT). Twelve patients diagnosed as cor pulmonale and 32 control subjects were also included. The RV function and myocardial mass (MM) were obtained by 64-MDCT and 1.5 T cardiac MRI in all of the groups. The results were compared among the groups using the Newman–Keuls method. Pearson's correlation was used to evaluate the relationship between the right ventricular ejection fraction (RVEF) and MM with the PFT results in COPD and cor pulmonale patients.

Results

The RVEF was significantly lower in patients with severe COPD and cor pulmonale than it was in those patients with mild or moderate COPD (P < 0.01). There were strong correlations between MDCT and MRI (r = 0.826 for RV MM, r = 0.982 and 0.969 for RV EDV and RV ESV, r = 0.899 for RVEF) and between MDCT results and forced expiratory volume in 1 s (r = 0.787 for RVEF, r = −0.774 for RV MM) in all patients.

Conclusion

MDCT can accurately quantify RV function and MM. The RVEF and RV MM measured by MDCT correlate well with the severity of disease as determined by PFT in patients with COPD and cor pulmonale. The assessment of right ventricular function is clinically important for evaluation of the severity of COPD, which may provide an objective basis for therapeutic strategy.     

Automatic quantification of right ventricular volumes and right ventricular ejection fraction with gated blood pool SPECT: Comparison of 8- and 16-frame gated blood pool SPECT with first-pass radionuclide angiography

BACKGROUND: The aim of this study was to compare 8- and 16-frame gated blood pool single photon emission computed tomography (SPECT) (GBPS) for the determination of right ventricular ejection fraction (RVEF) and right ventricular (RV) volumes in subjects who underwent two consecutive GBPS studies. METHODS AND RESULTS: In this study 65 consecutive patients (29 men and 36 women) referred for first-pass radionuclide angiography (FP-RNA) underwent FP-RNA and both 8- and 16-frame GBPS. The mean FP-RNA RVEF was statistically lower than RVEF determined by 8-frame GBPS (P < .001) and 16-frame GBPS (P < .001). Comparison of RVEF by FP-RNA and GBPS yielded coefficients of 0.8666 (P < .0001) for 16-frame GBPS and 0.7290 (P < .0001) for 8-frame GBPS. The correlation of RVEF between 8- and 16-frame GBPS showed a coefficient of 0.6657 (P < .0001). The mean RV end-diastolic volume (EDV) calculated with 8- and 16-frame GBPS showed no statistical differences (P = .3580). The mean RV end-systolic volume (ESV) calculated with 8- and 16-frame GBPS also showed no statistical differences (P = .2265). Comparison of EDV by 8- and 16-frame GBPS yielded a coefficient of 0.7327 (P < .0001). The correlation between ESV by 8-frame GBPS and 16-frame GBPS showed a coefficient of 0.6067 (P < .0001). CONCLUSION: GBPS is a simple and reproducible acquisition method for the assessment of RVEF and RV volumes. RVEF values calculated by 8- and 16-frame GBPS correlated well with FP-RNA, although mean RVEF values from FP-RNA were lower than GBPS RVEF values. In addition, RV ESV and EDV were both well correlated with 8- and 16-frame GBPS. GBPS should prove to be useful in diagnosis, as well as in following disease progression and evaluating the efficacy of therapeutic interventions, in patients with biventricular dysfunction.     

回顾性心电门控多层螺旋CT对急性肺栓塞右心室功能障碍及溶栓前后右心室功能变化的评价

目的 应用ECG门控MSCT前瞻性对中心型急性肺动脉栓塞(APE)患者右心功能障碍及静脉溶栓前后右心功能变化进行评价.方法 96名可疑APE患者进行了ECG门控MSCT胸痛三联检查,25例确诊为中心型肺栓塞.行胸痛三联检查无心肺疾患且性别、年龄匹配的25例作为对照组.APE患者于静脉溶栓后复查MSCT,评价右心功能恢复情况.测量参数包括横断面舒张期的右心室(RV)及左心室(LV)短轴最大内径,RV及LV舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、主肺动脉/主动脉直径比.应用单因素方差分析,如果有统计学意义,则采用两两组间q检验.结果 对照组的右心室EDV、ESV、EF值、收缩末期RV/LV容积比、横断面RV/LV内径比及主肺动脉/主动脉直径比分别为(15O.5±24.1)ml、(71.5±18.5)ml、(53.5±4.2)%、1.08±0.04、1.01±0.04及0.99±0.02,中心型APE患者溶栓前以上各值分别为(190.3±16.2)ml、(128.1±13.2)ml、(32.7±3.6)%、2.00±0.26、1.30±0.09及1.34±0.11,溶栓后分别为(159.2±21.5)ml、(80.7±9.4)ml、(49.2±5.9)%、1.22±0.25、1.02±0.02及1.02±0.11.中心型APE患者与对照组比较,右心室ESV(q=6.28,P<0.01)及EDV均增大(q=7.59,P<0.01),EF减小(q=4.82,P<0.01),收缩末期RV/LV容积比增大(q=6.04,P<0.01),横断面RV/LV内径比(q=4.43,P<0.01)及主肺动脉/主动脉直径比增大(q=4.36,P<0.01),左心室EDV减小.中心型APE患者静脉溶栓后,与溶栓前比较,右心室ESV(q=5.03,P<0.01)及EDV减小(q=6.11,P<0.01),EF增加(q=6.29,P<0.01),收缩末期RV/LV容积比减小(q=4.74,P<0.01),横断面RV/LV内径比(q=3.83,P<0.01)及主肺动脉/主动脉直径比减小(q=3.46,P<0.01),左心室EDV增大(q=4.01,P<0.01).结论 回顾性ECG门控MSCT胸痛三联检查可同时检测APE和测量左右心功能,排除其他胸痛疾病,评价溶栓疗效.     

应用实时三维超声心动图测量右室容积的实验研究

目的:利用实时三维超声心动图(RT 3DE)检测体外右室模型、离体猪右室的容积,并与实际容积及传统二维超声心动图(2DE)对照,探讨该技术的可行性与准确性。方法:使用RT 3DE系统采集10个不规则形状的橡胶水囊2、0例离体猪心脏右室“金字塔”型数据库,结合容积分析软件,采用三平面法勾画右室内膜面,计算右室容积;同时用二维超声的Simpson法测量右室容积;以注水法测量水囊及离体猪右室实际容量作为对照标准,分别将RT 3DE容积测量值、2DE测值与实际容积相比较。结果:在橡胶水囊容积测量中,RT 3DE测量的右室容积与实际值呈正相关(r=0.926),两者无显著性差异(P>0.05);2DE值与实际值呈正相关(r=0.682),两者有显著性差异(P<0.05)。离体猪右室组RT 3DE测量的右室容积与实际值呈正相关(r=0.858),与实际值无显著性差异(P>0.05);2DE右室值、右室流出道值及二者之和与实际值亦呈正相关(r=0.712,r=0.590,r=0.794),前两者与实际值有显著性差异(P<0.05),前两者之和与实际值无显著性差异(P>0.05)。结论:实时三维超声心动图能准确测量右室容积,为评价右室功能提供了新的有力的工具。     

Right ventricular volumes and ejection fraction with fast cine MR imaging in breath-hold technique: applicability, normal values from 52 volunteers, and evaluation of 325 adult cardiac patients

Our goal was to establish right ventricular (RV) volume and ejection fraction (EF) values in normal volunteers with fast magnetic resonance (MR) imaging using a breath-hold technique, to assess the frequency and severity of RVEF abnormality in cardiac patients and to compare RV with left ventricular (LV) data. We performed simultaneously derived RV and LV fast cine measurements in 52 normals and 325 patients with coronary artery disease (CAD), acquired valvular disease (VD), cardiomyopathy (CM), or congenital heart disease (CHD). RVEF was reduced in 31% (102) of all patients, in 50% dilated CM, 39% CHD, 34% CAD, and 22% acquired VD patients. Solitary abnormally low RVEF was found in only 15/325 (5%) of all patients, whereas combined with LVEF deterioration in 87/172 (51%) patients. RVEF reduction was mild in 64%, moderate in 25%, and severe in 11%. Although RVEF correlated significantly (r = 0.55, P < 0.001) with LVEF, the predictive value of LVEF for RVEF was low. We conclude that RV volumes can be routinely assessed with fast MRI and should be performed in addition to LV evaluation in CHD, in right-sided VD, and in all patients with an abnormal LVEF.J. Magn. Reson. Imaging 1999; 10:908-918.     

Assessment of the Right Ventricular Function and Mass Using Cardiac Multi-Detector Computed Tomography in Patients with Chronic Obstructive Pulmonary Disease

Objective

We wanted to assess the relationship between measurements of the right ventricular (RV) function and mass, with using cardiac multi-detector computed tomography (MDCT) and the severity of chronic obstructive pulmonary disease (COPD) as determined by the pulmonary function test (PFT).

Materials and Methods

Measurements of PFT and cardiac MDCT were obtained in 33 COPD patients. Using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, the patients were divided into three groups according to the severity of the disease: stage I (mild, n = 4), stage II (moderate, n = 15) and stage III (severe, n = 14). The RV function and the wall mass were obtained by cardiac MDCT. The results were compared among the groups using the Student-Newman-Keuls method. Pearson''s correlation was used to evaluate the relationship between the right ventricular ejection fraction (RVEF) and the wall mass results with the PFT results. P-values less than 0.05 were considered statistically significant.

Results

The RVEF and mass were 47±3% and 41±2 g in stage I, 46±6% and 46±5 g in stage II, and 35±5% and 55±6 g in stage III, respectively. The RVEF was significantly lower in stage III than in stage I and II (p < 0.01). The RV mass was significantly different among the three stages, according to the disease severity of COPD (p < 0.05). The correlation was excellent between the MDCT results and forced expiratory volume in 1 sec (r = 0.797 for RVEF and r = -0.769 for RV mass) and forced expiratory volume in 1 sec to the forced vital capacity (r = 0.745 for RVEF and r = -0.718 for RV mass).

Conclusion

Our study shows that the mean RV wall mass as measured by cardiac MDCT correlates well with the COPD disease severity as determined by PFT.     

Right ventricular function in healed myocardial infarction in man. A cineangiographic assessment

To evaluate the frequency of right ventricular dysfunction following recovery from myocardial infarction (MI) and the relationship of segmental right ventricular (RV) wall motion abnormalities to left ventricular (LV) function or location of coronary arterial stenosis, biplane right and left ventricular cineangiograms were obtained in 100 consecutive patients (4 +/- 3 months post MI). Thirty (group A) had anterior MI and significant stenosis or obstruction of left anterior descending artery (LAD). The remaining 70 patients had inferior MI. They were divided into three groups according to the site of the main coronary stenosis or obstruction and corresponding LV akinesia: right coronary artery (RCA) proximal to the acute marginal artery (RMA), (group B: 32 patients), RCA distal to the RMA (group C: 18 patients), left circumflex artery (LCF), (group D: 18 patients). RV and LV end-diastolic volume index (EDV), end-systolic volume index (ESV), stroke volume (SV) and ejection fraction (EF) have been determined. RV segmental wall motion was assessed in RAO and LAO projection by determining the percentage of systolic shortening (+ delta R) along 11 hemiaxes. Mean axial shortening (delta R) of the RV inferior and free walls were considered. When compared with that in 10 normal subjects, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV) were increased and RV ejection fraction (RVEF) was lower in patients with anterior or inferior MI. Inferior delta R exhibited comparable sequential changes in the three groups of inferior MI and similar LVEF alteration.(ABSTRACT TRUNCATED AT 250 WORDS)