Utilization of the flow ratio measured by echocardiography (FR_echo) compared to the flow ratio by right heart catheterization (FR_rhc) for detecting Eisenmenger syndrome in uncorrected acyanotic adult congenital heart disease (ACHD).

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2025-04-25 DOI:10.1186/s12880-025-01651-y

Charlotte Johanna Cool, Achmad Fitrah Khalid, Norman Sukmadi

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引用次数: 0

Abstract

Background: The increasing number of adult congenital heart disease (ACHD) patients, especially in low- and middle-income countries (LMICs), necessitates effective management methods. The Qp/Qs or flow ratio (FR) is crucial for this purpose because one of the indications for closure is a significant shunt. This study compares the utility of the transthoracic echocardiography (TTE)-derived flow ratio (FR_echo) with that of the right heart catheterization (RHC)-derived flow ratio (FR_rhc) to guide clinical decisions in resource-limited settings.

Materials and methods: This cross-sectional study in Bandung, Indonesia, included 36 patients with uncorrected acyanotic ACHD who underwent both RHC and TTE on the same day. FR_echo was calculated using stroke volumes of the respective ventricles derived from Doppler measurements, and FR_rhc was measured using indirect Fick's method.

Results: Of the 36 patients, 80.6% were female, with a median age of 31 (18-65) years. The majority had secundum atrial septal defects (61.1%). The mean FR_echo was 2.8 ± 1.5 and the median FR_rhc was 1.69 (0.46-3.89). FR_echo showed a significant positive correlation with FR_rhc (ρ = 0.656, p < 0.001). Bland‒Altman analysis revealed a mean difference of 1 (-1.4-3.3). Subgroup analysis of patients with a FRrhc shunt < 1 showed a mean difference of 0.7 (-1-2.3).

Conclusion: TTE-derived FR_echo tends to overestimate FR compared to FR_rhc. FR_echo should not be used as a surrogate for FR_rhc in this population.

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利用超声心动图（FRecho）测量的流量比与右心导管（FRrhc）测量的流量比在未纠正的无青紫型成人先天性心脏病（ACHD）中检测艾森门格综合征的应用

背景：成人先天性心脏病（ACHD）患者数量的增加，特别是在低收入和中等收入国家（LMICs），需要有效的管理方法。Qp/Qs或流量比（FR）对于这一目的至关重要，因为关闭的标志之一是明显的分流。本研究比较了经胸超声心动图（TTE）衍生的流量比（FRecho）和右心导管（RHC）衍生的流量比（FRrhc）在资源有限的情况下指导临床决策的效用。材料和方法：本横断面研究来自印度尼西亚万隆，包括36例未纠正的无氰性ACHD患者，他们在同一天接受了RHC和TTE手术。FRecho通过多普勒测量得到的各心室的脑卒中容积计算，FRrhc采用间接菲克法测量。结果：36例患者中，女性占80.6%，中位年龄31岁（18 ~ 65岁）。继发性房间隔缺损占多数（61.1%）。平均FRecho为2.8±1.5，中位FRrhc为1.69（0.46-3.89）。FRecho与FRrhc呈显著正相关（ρ = 0.656, p）。结论：与FRrhc相比，tte衍生的FRecho倾向于高估FR。在这一人群中，FRecho不应作为FRrhc的替代品。

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

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.