三尖瓣环收缩期运动幅度评价充血性心力衰竭患者预后的价值

目的探讨用三尖瓣环收缩期运动幅度(TAPSE)评价充血性心力衰竭患者预后的重要价值。方法研究对象为48例心功能(NYHA)Ⅲ～Ⅳ级的充血性心力衰竭(CHF)患者和30例正常对照者。常规应用超声心动图测定各组的右室内径(RVD

Prognostic value of tricuspid annular plane systolic excusion in patients with congestive heart failure by echocardiography

Objective　To explore the prognostic value of tricuspid annular plane systolic excusion (TAPSE) in patients with congestive heart failure (CHF) by echocardiography.Methods　The study population consisted of 48 consecutive patients with CHF (NYHA class Ⅲ-Ⅳ) and 30 normal control (NC) group. All study population underwent a complete echocardiographic evaluation that included systematically measuement of right ventricular end-diastolic diameter (RVDd),right atrial area (RAA), right ventricular area (RVA), right ventricular free wall thickness (RVFWT), right ventricular ejection fraction (RVEF), mitral valve peak velocity E, peak velocity A , A/E ratio,peak velocity E deceleration time (EDT) and TAPSE.Results　The parameters of cardiac function in CHF group were significant different from those in NC group (P<0.05～0.001). RVDd,RAA,RVA,RVEDV,RVESV,RVSV,peak velocity E, and peak velocity A were increased (P<0.01～0.001),but RVFWT,TAPSE,A/E ratio ,EDT and RVEF were decreased (P<0.01～0.001), a close correlation were found between TAPSE and RVEF or LVEF (r=0.76 or r=0.78,P<0.001) in patients with CHF. During follow-up period (20±11) months,12 patients died with sudden cardiac death（SCD）. Univariate analyses showed that RVDd>31 mm、TAPSE≤14 mm、LVEF<35% and EDT<120 ms were significant prognostic information to NYHA class Ⅲ～Ⅳ(P<0.001), Multivariate analysis showed that TAPSE and LVEF were independent predictors of outcome.Conclusions　The measurements of TAPSE is easy to obtain in all patients including irrespective of heart rate and rhythm.The TAPSE not only reflects severity of NYHA class ,but also have important value for evalution the prognostic in patients with CHF.