ABSTRACT
Objective To evaluate right ventricular (RV) global and regional systolic function using real-time three-dimensional echocardiography (RT-3DE) in patients with pulmonary hypertension (PH).Methods Thirty patients with PH and 27 controls were studied.RT-3DE images were acquired on a Philipa iE33 system with an X3-1 probe,then analyzed with a new software(TomTec) to determine RV global and regional (inflow, body, outflow) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF).The difference of RT-3DE parameters between the two groups,as well as the correlation between RT-3DE and routine echoeardiography parameters was analyzed.Results In patients with PH ,RV global and regional EDV and ESV were significantly higher than those in normal controls (all P ＜0.05); RV global and regional EF were significantly lower than those in normal controls (all P ＜0.05).In the PH group, RV inflow EDV,SV and EF were higher than that of RV body and outflow part (P ＜ 0.05) ;RV global EF was lower than that of RV inflow part and higher than that of RV body and outflow part.In the PH group, RV global and inflow EF correlated with pulmonary artery systolic pressure negatively (r = - 0.611, P ＜0.001 and r = - 0.576, P = 0.001 ,respectively) ,and with the ratio of peak velocity of tricuspid regurgitation over outflow time-velocity integral negatively (r = -0.772, P = 0.002and r = -0.721, P ＜0.001, respectively)Conclusions RV global and regional volume was enlarged and systolic function was impaired in patients with pulmonary hypertension.RV global and regional systolic function was changed in liner relationship with RV after-load.
ABSTRACT
Objective To investigate the feasibility and accuracy of velocity vector imaging(VVI)to assess strain and strain rate of right ventrieule(RV)during varying myocardial functional states.Methods VVI of the longitudinal RV were recorded in 7 closed-chest anesthetized mongrel dogs from the apical 4-chamber view during 3 different inotropic states.Peak dp/dt from the RV contraction during the right cardiac catheterization,which was used as the gold standard of RV contractility,was obtained simultaneously in each inotropic state.Peak systolic velocities(V), peak systolic strain rates(SR),peak systolic strains(S)at the basal, middle and apical segments of RV free wall and septal from the longitudinal axis were quantitatively measured by using VVI software system respectively.Results The peak systolic strain and strain rate of the longitudinal RV free wall and septal were increased with the infusion of dobutamine and decreased with the infusion of metoprolol.A significant correlation was found between peak RV dp/dt and RV mean strain and mean strain rate(r=0.79, 0.75;P <0.01).Among all RV segments, the peak systolic S,SR of RV basal free wall had the most significant correlation to peak dp/dt (r=0.83,0.78;P<0.01).Conclusions Strain rate imaging drived from VVI could quantitatively and sensitively detect the longitudinal RV contractile function.Peak systolic S and SR determined at the longitudinal RV basal free wall were the strong noninvasive indices of RV contractility.