肺移植候选者的右心室游离壁纵向应变筛选。

IF 2.6 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES
PLoS ONE Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI:10.1371/journal.pone.0314235
Vittorio Scaravilli, Silvia Scansani, Paolo Meani, Gloria Turconi, Amedeo Guzzardella, Marco Bosone, Claudia Bonetti, Marco Vicenzi, Letizia Corinna Morlacchi, Valeria Rossetti, Lorenzo Rosso, Francesco Blasi, Mario Nosotti, Giacomo Grasselli
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引用次数: 0

摘要

背景:肺移植(LUTX)候选人有亚临床右心室(RV)功能障碍,尚未通过斑点跟踪超声心动图(STE)衍生的右心室自由壁纵向应变(RVFWLS)进行评估。评价左室功能障碍的RVFWLS患病率及其与常规左室超声心动图指标的关系。方法:在一项单中心前瞻性观察队列研究中,从2021年1月至2023年3月,连续LUTX患者接受了心导管置入术、放射性核素心室造影、标准和STE检查。计算心室造影诊断右心室射血分数(RVEF)、三尖瓣环平面偏移(TAPSE)、分数面积变化(FAC)、三尖瓣峰值环收缩速度(S’)与RVFWS的诊断准确性。结果:34例患者(女性,41%),平均年龄48岁[36-59],因肺纤维化(35%)和囊性纤维化(30%)入选。在心导管检查中,只有7例(23%)有肺动脉高压。约15-25%表现为右心增大。20例(60%)患者出现三尖瓣反流。中位RVFWLS为-20.1%[-22.5%- 17%],16例(47%)患者出现> -20%的损伤。与TAPSE(32%)、S'(27%)、FAC(26%)和脑室造影(15%)相比,RVFWLS检测心室功能障碍的比例最高(47%),而后者检测心室功能障碍的灵敏度非常低。结论:在接受LUTX治疗的患者中,通过ste衍生的RVFWLS评估的RV功能障碍非常普遍。超声心动图对左室功能障碍的检测效果优于标准二维超声心动图和心室造影。目前迫切需要进一步的研究来确定RVFWLS测量的右室功能障碍的临床意义和预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Right ventricle free wall longitudinal strain screening of lung transplant candidates.

Right ventricle free wall longitudinal strain screening of lung transplant candidates.

Right ventricle free wall longitudinal strain screening of lung transplant candidates.

Right ventricle free wall longitudinal strain screening of lung transplant candidates.

Background: Lung transplant (LUTX) candidates have subclinical right ventricular (RV) dysfunction, which has not yet been assessed by speckle-tracking echocardiography (STE)-derived RV free-wall longitudinal strain (RVFWLS). To evaluate the prevalence of RV dysfunction by RVFWLS and its relationship with conventional RV echocardiographic indexes in LUTX candidates.

Methods: In a single-center prospective observational cohort study, from January 2021 to March 2023 consecutive LUTX candidates underwent cardiac catheterization, radionuclide ventriculography, standard and STE. The diagnostic accuracy of RV ejection fraction by ventriculography (RVEF), tricuspid annular plane excursion (TAPSE), fractional area change (FAC), tricuspid peak annulus systolic velocity (S') versus RVFWS were computed.

Results: Thirty-four patients (female, 41%) with a mean age of 48 [36-59] years old enlisted for pulmonary fibrosis (35%) and cystic fibrosis (30%) were included. At cardiac catheterization, only 7 (23%) had pulmonary hypertension. Around 15-25% presented right heart enlargement. Tricuspid regurgitation was present in 20 (60%) of the patients. Median RVFWLS was -20.1% [-22.5%--17%], being impaired (> -20%) in 16 (47%) of the patients. RVFWLS identified the highest percentage (47%) of RV dysfunction, compared to TAPSE (32%), S' (27%), FAC (26%), and ventriculography (15%), which had very low sensitivity for detecting RV dysfunction compared to RVFWLS.

Conclusions: In patients enlisted for LUTX, RV dysfunction assessed by STE-derived RVFWLS is highly prevalent. STE can detect RV dysfunction better than standard two-dimensional echocardiography and ventriculography. Further studies are urgently needed to define the clinical implications and the prognostic value of RV dysfunction measured with RVFWLS.

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来源期刊
PLoS ONE
PLoS ONE 生物-生物学
CiteScore
6.20
自引率
5.40%
发文量
14242
审稿时长
3.7 months
期刊介绍: PLOS ONE is an international, peer-reviewed, open-access, online publication. PLOS ONE welcomes reports on primary research from any scientific discipline. It provides: * Open-access—freely accessible online, authors retain copyright * Fast publication times * Peer review by expert, practicing researchers * Post-publication tools to indicate quality and impact * Community-based dialogue on articles * Worldwide media coverage
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