Measuring isovolumic contraction peak velocity at the tricuspid annulus by Doppler tissue imaging to ;assess right heart function in patients with pulmonary hypertension
10.3877/cma.j.issn.1672-6448.2014.03.003
- VernacularTitle:组织多普勒成像测量三尖瓣环等容收缩期峰值速度在评价肺高压患者右心功能中的应用
- Author:
Liqun, WEI
;
Yue, LI
;
Guangyi, WANG
;
Hang, ZHU
;
Juan, WANG
;
Yanan, ZHAI
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Ultrasonography,Doppler;
Hypertension,pulmonary;
Ventricular function,right
- From:
Chinese Journal of Medical Ultrasound (Electronic Edition)
2014;(3):8-12
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility and accuracy of the isovolumic contraction peak velocity (IVCv) of right heart function in patients with pulmonary hypertension (PH) by echocardiography and Doppler tissue imaging. Methods In 41 patients with suspected diagnosis of PH, IVCv at the tricuspid annulus were measured by echocardiography and Doppler tissue imaging. The right heart systolic function parameters such as tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity (PSv) and right ventricular fractional area change (RVFCA) were also measured. The pulmonary artery pressure was detected by right-heart catheterization (RHC). According to different levels of pulmonary arterial systolic pressure, patients were classiifed into four groups to compare and analyze if any signiifcance could be found, including without PH group, mild PH group, moderate PH group and severe PH group. The sensitivity and speciifcity for diagnosing right heart impairment were assessed by ROC curves. Last, correlation analysis was performed. Results IVCv was signiifcantly and positively correlated with the right heart systolic function parameters, such as TAPSE (r=0.557, P<0.001), PSv (r=0.714, P<0.001) and RVFCA (r=0.341, P<0.05). Negative correlation existed between IVCv and PASP (r=-0.739, P<0.001). The average IVCv of without PH group, mild PH group, moderate PH group and severe PH group were (13.83±3.56) cm/s, (10.11±1.36) cm/s, (8.70±2.21) cm/s and (5.80±1.03) cm/s, respectively. The level of IVCv was obviously lower in severe PH group than those in without PH group, mild PH group and moderate PH group. The difference was signiifcant (P<0.05). The levels of IVCv increased obviously in without PH group than those in mild PH group and moderate PH group (P<0.01). There were no differences for IVCv between mild PH group and moderate PH group (P>0.05). Using the lower limit of right ventricular systolic function parameter obtained by common echocardiographic assessment as standard (TAPSE<16 mm, PSv<10 cm/s and RVFAC<35%), the sensitivities of IVCv<6.5 cm/s for diagnosing right ventricular systolic function reduction were 91%, 96%and 87%and the speciifcities were 70%, 53%and 77%, respectively. Conclusions IVCv obtained by Doppler tissue imaging is a new objective parameter for diagnosing right ventricular systolic function reduction. It is worth further study and application in clinic.
