Evaluation of right ventricular function in patients with Behcet's disease by four-dimensional echocardiography

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2024-08-30 DOI:10.1111/echo.15918

Zeynep Ulutas MD, Hakan Tasolar MD, Mirac Karaagac MD, Siho Hidayet MD, Yucel Karaca MD, Adil Bayramoglu MD, Servet Yolbas MD, Julide Akaycan MD, Necip Ermis MD, Mehmet Cansel MD, Hasan Pekdemir MD

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引用次数: 0

Abstract

Aim

Behcet's disease (BD) is a systemic disorder characterized by vasculitis, resulting in thickened vascular walls that reduce elasticity and impair function. BD can involve the cardiovascular system in three ways: cardiac, arterial, and venous. In this study, our objective was to evaluate the efficacy of pulmonary arterial stiffness (PAS) and pulmonary pulse transit time (PPTT) measures in demonstrating right ventricular functions in asymptomatic BD patients. We aimed to objectively evaluate right ventricular function in patients with BD using four-dimensional echocardiography (4DE).

Method

This study included 40 patients diagnosed with BD and 40 healthy subjects. Demographic, clinical, laboratory, and echocardiographic parameters were compared. In addition to standard transthoracic echocardiographic evaluation, right ventricle quantification (RVQ) by using the 4DE and 2D-speckle tracking echocardiography were performed.

Results

The sPAP, 4D RVQ, and right ventricular strain values exhibited significant differences between the BD and control groups. Right ventricular end-diastolic diameter (RVDD), right ventricular end-systolic diameter (RVSD), right atrium (RA) area, right ventricular myocardial performance index (RVMPI), and PAS were increased in BD patients compared to the control group. Right ventricular ejection fraction (RVEF), right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), Tricuspid S’, and PPTT were decreased in BD patients compared to control subjects. PPTT correlated with right ventricular free wall strain (RV-FWS) and PAS. In a multivariate linear regression analysis, PAS and RVFAC were found to be independent predictors of RVFWS. In addition, RVFAC and TAPSE are independent predictors for PPTT.

Conclusion

Patients with BD may have elevated pulmonary arterial stiffness (PAS) in correlation with decreased PPTT. To ascertain the prognosis for these individuals, right ventricular (RV) functions must be evaluated. Measurements of RVFAC and RVEF via 4DE and deformation imaging techniques may be more useful in identifying subclinical impairment of RV. Individuals with BD, PAS, and PPTT may suggest a link between early pulmonary vascular remodeling and RV subclinical impairment.

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通过四维超声心动图评估白塞氏病患者的右心室功能

目的白塞氏病（BD）是一种以血管炎为特征的全身性疾病，会导致血管壁增厚、弹性降低和功能受损。白塞氏病可通过三种方式累及心血管系统：心脏、动脉和静脉。在这项研究中，我们的目的是评估肺动脉僵硬度（PAS）和肺脉搏转运时间（PPTT）测量方法在显示无症状 BD 患者右心室功能方面的功效。我们旨在使用四维超声心动图（4DE）客观评估 BD 患者的右心室功能。方法本研究包括 40 名确诊为 BD 的患者和 40 名健康受试者。比较了人口统计学、临床、实验室和超声心动图参数。除了标准的经胸超声心动图评估外，还使用 4DE 和二维斑点追踪超声心动图进行了右心室定量分析（RVQ）。结果 BD 组和对照组的 sPAP、4D RVQ 和右心室应变值有显著差异。与对照组相比，BD 患者的右心室舒张末期直径（RVDD）、右心室收缩末期直径（RVSD）、右心房面积（RA）、右心室心肌性能指数（RVMPI）和 PAS 均有所增加。与对照组相比，BD 患者的右室射血分数（RVEF）、右室分区面积变化（RVFAC）、三尖瓣环平面收缩期偏移（TAPSE）、三尖瓣 S' 和 PPTT 均下降。PPTT 与右心室游离壁应变（RV-FWS）和 PAS 相关。在多变量线性回归分析中，发现 PAS 和 RVFAC 是 RVFWS 的独立预测因子。此外，RVFAC 和 TAPSE 也是 PPTT 的独立预测因子。结论 BD 患者的肺动脉僵硬度（PAS）升高可能与 PPTT 下降相关。要确定这些患者的预后，必须对右心室（RV）功能进行评估。通过 4DE 和形变成像技术测量 RVFAC 和 RVEF 可能更有助于识别 RV 的亚临床损伤。具有 BD、PAS 和 PPTT 的个体可能提示早期肺血管重塑与 RV 亚临床损害之间存在联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.