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肺动脉高压的发展会导致患者右室功能减低,对肺动脉高压患者右室功能的评价对其预后具有十分重要的临床意义。随着超声技术的不断发展,特别是新型超声技术的出现能敏感、准确地定量反映肺动脉高压患者的右室功能。现就目前超声心动图技术在评价肺动脉高压患者右室功能中的应用做一综述。 相似文献
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肺动脉高压会导致患者右室功能减低,早诊断、早治疗肺动脉高压能明显改善患者的预后。近年来应用多普勒超声技术对肺动脉高压患者右室功能研究的新进展层出不穷,如双多普勒同步技术、Tei指数及三尖瓣环收缩期位移等,均为临床提供了全新的评价肺动脉高压及右室功能的新手段及新参数。 相似文献
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Left Ventricular Function in Patients with Pulmonary Arterial Hypertension: The Role of Two‐Dimensional Speckle Tracking Strain 下载免费PDF全文
Ricardo de Amorim Corrêa M.D. Ph.D. Fernanda Brito de Oliveira M.D. Marcia M. Barbosa M.D. Ph.D. Jose Augusto A. Barbosa M.D. Ph.D. Taís Soares Carvalho Michele Campos Barreto Frederico Thadeu A. F. Campos M.D. Maria Carmo Pereira Nunes M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(9):1326-1334
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Doron Aronson Wisam Darawsha Aula Atamna Marielle Kaplan Badira F. Makhoul Diab Mutlak Jonathan Lessick Shemy Carasso Shimon Reisner Yoram Agmon Robert Dragu Zaher S. Azzam 《Journal of cardiac failure》2013,19(10):665-671
BackgroundPulmonary hypertension (PH) and right ventricular (RV) dysfunction have been associated with adverse outcome in patients with chronic heart failure. However, data are lacking in the setting of acute decompensated heart failure (ADHF). We sought to determine prognostic significance of PH in patients with ADHF and its interaction with RV function.MethodsWe studied 326 patients with ADHF. Pulmonary artery systolic pressure (PASP) and RV function were determined with the use of Doppler echocardiography, with PH defined as PASP >50 mm Hg. The primary end point was all-cause mortality during 1-year follow-up.ResultsPH was present in 139 patients (42.6%) and RV dysfunction in 83 (25.5%). The majority of patients (70%) with RV dysfunction had PH. Compared with patients with normal RV function and without PH, the adjusted hazard ratio (HR) for mortality was 2.41 (95% confidence interval [CI] 1.44–4.03; P = .001) in patients with both RV dysfunction and PH. Patients with normal RV function and PH had an intermediate risk (adjusted HR 1.78, 95% CI 1.11–2.86; P = .016). Notably, patients with RV dysfunction without PH were not at increased risk for 1-year mortality (HR 1.04, 95% CI 0.43–2.41; P = .94). PH and RV function data resulted in a net reclassification improvement of 22.25% (95% CI 7.2%–37.8%; P = .004).ConclusionsPH and RV function provide incremental prognostic information in ADHF. The combination of PH and RV dysfunction is particularly ominous. Thus, the estimation of PASP may be warranted in the standard assessment of ADHF. 相似文献
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Antonello D'Andrea M.D. Ph.D. Anna Stanziola M.D. Enza Di Palma M.D. Maria Martino M.D. Michele D'Alto M.D. Santo Dellegrottaglie M.D. Rosangela Cocchia M.D. Lucia Riegler M.D. Meredyth Vanessa Betancourt Cordido M.D. Maurizia Lanza M.D. Marco Maglione M.D. Veronica Diana M.D. Raffaele Calabrò M.D. Maria Giovanna Russo M.D. Mani Vannan M.D. Eduardo Bossone M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(1):57-65
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Right Ventricular Strain before and after Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension 下载免费PDF全文
Nicholas Marston M.D. Jason P. Brown M.D. Nicholas Olson M.D. William R. Auger M.D. Michael M. Madani M.D. Darrin Wong M.D. Ajit B. Raisinghani M.D. Anthony N. DeMaria M.D. Daniel G. Blanchard M.D. 《Echocardiography (Mount Kisco, N.Y.)》2015,32(7):1115-1121
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Rengin Çetin Güvenç Nurgül Ceran Tolga Sinan Güvenç Hacer Ceren Tokgöz Yalçin Velibey 《Journal of cardiac failure》2018,24(9):583-593
Background
Involvement of right-sided heart chambers (RSHCs) in patients infected with human immunodeficiency virus (HIV) is common and is usually attributed to pulmonary arterial or venous hypertension (PH). However, myocardial involvement in patients with HIV is also common and might affect RSHCs even in the absence of overt PH. Our aim was to define morphologic and functional alterations in RSHC in patients with HIV and without PH.Methods and Results
A total of 50 asymptomatic patients with HIV and 25 control subjects without clinical or echocardiographic signs for PH were included in the study. Transthoracic echocardiography was used to obtain measurements. Patients with HIV had significantly increased right ventricular end-diastolic diameter (RVEDD) and right ventricular free wall thickness (RVFWT), as well as increased right atrial area and pulmonary arterial diameter, compared with control subjects. After adjustment for age, sex, and body surface area, RVFWT (average 1.81 mm, 95% confidence interval [CI] 0.35–3.26 mm) and RVEDD (average 6.82 mm, 95% CI 2.40–11.24 mm) were significantly higher in subjects infected with HIV. More patients with right ventricular hypertrophy were on antiretroviral treatment, and RVFWT was on average 1.3 mm higher (95% CI 0.24–2.37 mm) in patients on antiretroviral treatment after adjustment for confounders.Conclusions
These findings suggest that alterations in RSHCs were present in patients with HIV without PH. 相似文献9.
Right Ventricular Strain in Pulmonary Arterial Hypertension: A 2D Echocardiography and Cardiac Magnetic Resonance Study 下载免费PDF全文
Benjamin H. Freed M.D. Wendy Tsang M.D. Nicole M. Bhave M.D. Amit R. Patel M.D. Lynn Weinert B.Sc. Megan Yamat R.D.C.S. Beatriz Miralles Vicedo M.D. Karin Dill M.D. Victor Mor‐Avi Ph.D. Mardi Gomberg‐Maitland M.D. Roberto M. Lang M.D. 《Echocardiography (Mount Kisco, N.Y.)》2015,32(2):257-263
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PAUL B. TABEREAUX M.D. M.P.H. HARISH DOPPALAPUDI M.D. G. NEAL KAY M.D. F.A.H.A. F.A.C.C. H. THOMAS MCELDERRY M.D. VANCE J. PLUMB M.D. F.A.H.A. F.A.C.C. 《Journal of cardiovascular electrophysiology》2010,21(4):431-435
Limited Response to CRT in Patients with RVD . Introduction: Patients with left ventricular dysfunction (LVD) and LV dyssynchrony may respond to cardiac resynchronization therapy (CRT). However, right ventricular dysfunction (RVD) is a predictor of decreased survival in patients with LVD, and its influence on clinical response to CRT is unknown. The purpose of this study was to examine the effect of RVD on the clinical response to CRT. Methods and Results: A retrospective cohort of consecutive patients who underwent implantation of a CRT implantable cardioverter‐defibrillator (ICD) were included and deemed to have RVD based on a RV ejection fraction <0.40. A lack of response to CRT was defined as: death, heart transplantation, implantation of an LV assist device, absent improvement in NYHA functional class at 6 months or hospice care. Among 130 patients included (mean age 58 ± 11 years, 68.5% male, 87.7% Caucasian, 51.5% nonischemic cardiomyopathy), 77 (59.2%) had no response to CRT as defined above. Of the nonresponders, 43 (56%) had RVD and 34 (44%) did not have RVD (P = 0.02). After adjustment for age, race, gender, cardiomyopathy type, atrial fibrillation, serum sodium, and severe mitral regurgitation, RVD (adjusted OR = 0.34, 95%CI 0.14–0.82), female gender (adjusted OR = 0.36, 95%CI 0.14–0.95), and serum creatinine (adjusted OR = 0.25, 95%CI 0.09–0.71) were independently associated with decreased odds of response to CRT. There was a significant difference in survival of patients with and without RVD after CRT (log rank P = 0.01). Conclusion: RVD represents a strong predictor of lack of clinical response to CRT in patients with CHF due to LVD and should be considered when prescribing CRT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 431–435, April 2010) 相似文献
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Rasmussen CM Dyer D Wheeler K Donaghey L Kwan OL Dittrich HC 《Echocardiography (Mount Kisco, N.Y.)》1996,13(2):109-116
Automatic border detection (ABD) has been developed as a potentially useful means for evaluating ventricular function on line in an automatic fashion. Its success with tracking left ventricular function is established, but little is known about its ability to assess right ventricular (RV) function. Accordingly, 20 patients with severe pulmonary hypertension due to chronic thromboembolic disease underwent standard two-dimensional echocardiography and imaging with ABD before and after pulmonary thromboendarterectomy to correct pulmonary hypertension. ABD-derived results were compared to manually planimetered RV areas calculated from the apical four-chamber view. Doppler tricuspid regurgitant velocity fell significantly with surgery from 4.4 ± 0.6 to 2.9 ± 0.7 m / sec (P < 0.001). The mean values for RV areas derived by manual planimetry and ABD were similar, as was fractional area shortening, which improved significantly with surgery (manual 0.24 ± 0.01 preoperative vs 0.31 ± 0.11 postoperative, P < 0.05; and ABD 0.19 ± 0.05 preoperative vs 0.32 ± 0.15 postoperative, P < 0.001). There was, however, very little correlation between the individual values for ABD versus manually derived RV areas and fractional area shortening, with the best correlation being the RV end-diastolic areas after surgery (y = 0.684x + 7.9, r = 0.564, P = 0.01). These results demonstrate that both manually planimetered RV areas and those determined by ABD can adequately follow changes in ventricular function over time. However, variability within each technique may prevent direct comparison of the absolute values of the two techniques. 相似文献
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Andreas P. Kalogeropoulos M.D. William L. Border M.B. Ch.B. M.P.H. Vasiliki V. Georgiopoulou M.D. Maria A. Pernetz R.D.C.S. Sharon Howell R.D.C.S. Michael McConnell M.D. Stamatios Lerakis M.D. Javed Butler M.D. M.P.H. Wendy M. Book M.D. Randolph P. Martin M.D. 《Echocardiography (Mount Kisco, N.Y.)》2010,27(8):937-945
Background: The favorable outcomes of Eisenmenger syndrome (ES) relative to other forms of pulmonary arterial hypertension (PAH) have been partially attributed to a unique adaptation of the right ventricle (RV). However, conventional measures of RV function may not adequately express this adaptation. Methods: We studied 23 patients with ES (age 43 ± 17 years, 16 women, pulmonary artery systolic pressure [PASP] 93 ± 26 mmHg), 25 patients with PAH (age 44 ± 13 years, 17 women, PASP 92 ± 19 mmHg), and 25 subjects without known structural disease (age 45 ± 16 years, 17 women). We evaluated long‐ and short‐axis function of the RV with two‐dimensional strain and anatomical M‐mode echocardiography, respectively. Results: Long‐axis function of the RV was comparable between patients with ES and PAH although depressed relative to controls (global strain, ?15.6 ± 4.7, ?14.9 ± 4.3, and ?22.4 ± 2.8%, respectively, P < 0.001; global RV systolic strain rate, ?0.77 ± 0.26, ?0.84 ± 0.24, and ?1.11 ± 0.21 1/sec, respectively, P < 0.001). However, short‐axis RV function was significantly better in patients with ES versus those with PAH and preserved relative to controls (RV fractional shortening by anatomical M‐mode, median [interquartile range], 21%[14–33%], 14%[10–16%], and 26%[22–36%], respectively, P = 0.002 for ES vs. PAH, P = 0.09 for ES vs. controls). This differential was not reflected in conventional measures of RV function (fractional area change, 32 ± 10 vs. 29 ± 8% in ES and PAH, respectively, P = 0.26). Conclusion: In patients with ES, the RV is characterized by preserved short‐axis function, despite a depressed long‐axis function. Thus, conventional assessment of RV function might not be suitable for patients with ES. (Echocardiography 2010;27:937‐945) 相似文献
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肺动脉高压联合药物治疗的研究进展 总被引:2,自引:0,他引:2
肺动脉高压是一类以肺血管阻力进行性增高为主要特征,最终导致右心衰竭、功能严重受限、死亡的疾病。近年来肺动脉高压在单一药物治疗上取得一定疗效,而联合应用不同的药物取得最佳临床疗效是治疗肺动脉高压的新观点,可以发挥药物间的协同效应,降低单个药物的不良反应。现综述联合药物治疗肺动脉高压的临床应用进展。 相似文献
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Nicole Pristera B.A. Ray Musarra R.C.S. R.C.D.S. Robert Schilz D.O. Ph.D. Brian D Hoit M.D. F.A.S.E. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(1):105-116
The evaluation of pulmonary arterial hypertension (PAH) requires a multimodality approach that combines invasive and noninvasive imaging studies to ensure accurate diagnosis and classification. Given the complexity of the hemodynamic relationships between the left heart, pulmonary circulation, and right heart, the diagnosis of PAH is often a challenging task. Right heart catheterization is the gold standard for diagnosis, providing the hemodynamic information that defines the disease. Nonetheless, echocardiography continues to be a valuable tool in the approach to the patient with suspected PAH. Echocardiographic assessment generates a wealth of information about the response of the right heart to elevated pulmonary pressures and provides essential diagnostic and prognostic data to the clinician. Numerous measurements can be used to identify alterations in right heart morphology, pressure, and function; although each variable in isolation may have little utility, meaningful information is revealed when multiple parameters are considered together. In this article, we will review the echocardiographic measurements employed in assessment of the right heart and seek to clarify the role of echocardiography in the diagnostic workup of PAH. 相似文献
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Right ventricular free‐wall longitudinal speckle tracking strain in patients with pulmonary arterial hypertension under specific treatment 下载免费PDF全文
Hatice S. Kemal MD Meral Kayikcioglu MD Hakan Kultursay MD Ozcan Vuran MD Sanem Nalbantgil MD Nesrin Mogulkoc MD Levent Can MD 《Echocardiography (Mount Kisco, N.Y.)》2017,34(4):530-536