无创心肌做功评价肺动脉高压患者右室功能的价值

目的 探究无创心肌做功(MW)技术评估肺动脉高压(PH)患者右室功能的价值。方法 选取PH患者112例为病例组,根据肺动脉收缩压(PASP)分为轻度组33例、中度组45例、重度组34例,同时选取健康志愿者44例为对照组。测量常规超声心动图参数,用无创性心肌做功技术获取右室心肌做功(RVMW)参数,包括右室整体做功指数(RVGWI)、右室整体有用功 (RVGCW)、右室整体无用功(RVGWW)、右室整体做功效率(RVGWE)。比较四组间各参数差异,同时分析右室心肌做功(RVMW)参数与常规超声右室功能参数间的相关性。结果 RVGWI、RVGCW及RVGWW随PASP增加逐渐增高,而RVGWE随PASP增加逐渐减低。RVGWI、RVGCW在各组间差异均具有统计学意义(P均<0.05)。与其余三组相比,RVGWE在重度组表现出明显降低(P均<0.05)。RVMW与常规超声右室功能参数间存在相关性(P均<0.01)。结论 无创RVMW可定量评估不同程度PH患者的右室功能。

The value of noninvasive myocardial work in the evaluation of right ventricular function in patients with pulmonary hypertension

Objective To explore the value of noninvasive myocardial work(MW) technique to evaluate the right ventricular function in patients with pulmonary hypertension (PH). Methods 112 patients with PH were selected, according to pulmonary arterial systolic pressure(PASP), 33 patients were divided into mild group, 45 in moderate group and 34 in severe group, meanwhile 44 healthy volunteers were selected as control group. Conventional echocardiographic parameters were measured, and the right ventricular myocardial work(RVMW) parameters were obtained using the noninvasive myocardial work technique,including right ventricular global work index(RVGWI),right ventricular global constructive work(RVGCW),right ventricular global wasted work (RVGWW),right ventricular global work efficiency(RVGWE).Differences between the parameters were compared between the four groups, and the correlation of right ventricular myocardial work(RVMW) parameters with conventional ultrasound right ventricular function parameters were also analyzed. Results RVGWI, RVGCW, and RVGWW gradually increased with increasing pulmonary arterial pressure, while RVGWE gradually decreased with increasing pulmonary arterial pressure.The differences of RVGWI and RVGCW in each group were statistically significant(P<0.05).The difference of RVGWE was statistically significant between severe and the remaining three groups(P<0.05).There was a correlation between the RVMW parameters and the conventional right ventricular function parameters(P<0.01). Conclusion Noninvasive RVMW allows for a quantitative assessment of RV function in patients with different grades of PH.