Clinical study on the changes of left ventricular function and recovery after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension
10.3760/cma.j.cn131148-20210818-00570
- VernacularTitle:慢性血栓栓塞性肺动脉高压患者左心室功能改变及肺动脉内膜剥脱术后恢复情况
- Author:
Gejing LIU
1
;
Aili LI
;
Yanan ZHAI
;
Guangjie LYU
;
Yanan ZHEN
;
Fan LIN
;
Xiaopeng LIU
;
Wanmu XIE
;
Zhenguo ZHAI
Author Information
1. 中日友好医院心脏科超声心动图室，北京 100029
- Keywords:
Echocardiography;
Chronic thromboembolic pulmonary hypertension;
Pulmonary endarterectomy;
Left ventricular systolic function;
Left ventricular longitudin
- From:
Chinese Journal of Ultrasonography
2022;31(3):245-251
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the configuration and systolic function of the left ventricle in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by routine ultrasound, two-dimensional speckle tracking imaging and three-dimensional echocardiography, and to observe the recovery after pulmonary endarterectomy (PEA).Methods:The patients who were diagnosed with CTEPH, underwent PEA and had no left heart disease were enrolled as the CTEPH group ( n=30) in the China-Japan Friendship Hospital from November 2016 and June 2021. The right heart catheterization data before and after surgery were recorded. In the meantime, gender- and age-matched healthy individuals who sought for physical examination during the same period were included as the control group ( n=23). Echocardiography findings before and after PEA were comparatively analyzed and compared between the two groups, including left ventricular end-diastolic diameter (LVEDd), right and left ventricular cross-section ratio (RVd/LVd), left ventricular global longitudinal strain (LVGLS), left ventricular end-diastolic/systolic volume index (LVEDVi/LVESVi), left ventricular ejection fraction (LVEF) and left ventricular stroke volume (LVSV). Associations between the mean pulmonary arterial pressure (mPAP)/pulmonary vascular resistance (PVR) and left ventricular function were discussed. Results:When compared with the control group, the LVEDd, LVEDVi, LVESVi, LVSV, LVGLS and the mitral early to late diastolic flow velocity ratio (E/A) in the CTEPH group were lower (all P<0.05). There were no significant differences between the two groups regarding LVEF, cardiac output (CO), and cardiac index (CI) (all P>0.05). There were no statistical differences of the left ventricular volume and LVSV between PEA group and the control group (both P>0.05), while the LVGLS and E/A remained lower (both P<0.05). Correlation analysis showed negative associations between mPAP and LVSV as well as E/A ( r=-0.490, -0.455; both P<0.05). Conclusions:There are changes in left ventricular configuration with abnormal filling pattern and potential systolic dysfunction in CTEPH patients. The PEA surgery could lead to recovery of the left ventricular configuration and volume, but the filling pattern and LVGLS at follow-up can not recover completely.
