{"title":"肺动脉闭锁和室间隔缺损患者行导管重建右室流出道后右室重构的定量计算机断层扫描评估：与超声心动图参数的相关性。","authors":"Hyun Woo Goo","doi":"10.1016/j.jcct.2025.05.236","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This retrospective study aimed to assess computed tomography (CT)-derived quantitative right ventricular (RV) remodeling patterns after RV outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect and correlate them with echocardiographic parameters.</p><p><strong>Methods: </strong>A total of 61 patients (90 CT volumetry studies, age: 16.2 ± 6.5 years) were retrospectively evaluated. Ventricular volume, myocardial mass, ejection fraction, stroke volume (SV), and SV difference were compared between the valveless and valved conduit groups; they were analyzed according to echocardiography-derived RV outflow tract pressure gradient and RV systolic pressure.</p><p><strong>Results: </strong>The valveless conduit group had smaller indexed left ventricular (LV) end-diastolic volume (83.4 ± 14.9 mL/m<sup>2</sup> [mean ± standard deviation] vs. 90.6 ± 17.6 mL/m<sup>2</sup>; p < 0.039) and indexed LV SV (43.0 ± 8.0 mL/m<sup>2</sup> vs. 48.0 ± 8.9 mL/m<sup>2</sup>; p < 0.006), larger indexed RV end-diastolic volume (118.0 ± 26.1 mL/m<sup>2</sup> vs. 98.1 [84.6-114.2] mL/m<sup>2</sup> [median {interquartile range}]; p = 0.010), indexed RV SV (62.5 ± 13.8 mL/m<sup>2</sup> vs. 49.3 ± 13.7 mL/m<sup>2</sup>; p < 0.001), and indexed SV difference (19.5 ± 12.3 mL/m<sup>2</sup> vs. -2.2 [-6.5-4.8] mL/m<sup>2</sup>; p < 0.001), and higher RV ejection fraction (53.2 ± 7.9 % vs. 48.7 [42.5-54.8]%; p = 0.018) than the valved conduit group. The moderate or severe pulmonary stenosis group had higher indexed RV myocardial mass (54.03 ± 15.1 g/m<sup>2</sup> vs. 43.8 [34.4-52.2] g/m<sup>2</sup>; p = 0.012); the moderately or severely elevated RV systolic pressure group had smaller indexed RV SV (53.4 ± 16.5 mL/m<sup>2</sup> vs. 62.8 ± 15.1 mL/m<sup>2</sup>; p < 0.032) and indexed SV difference (7.0 ± 14.7 mL/m<sup>2</sup> vs. 18.8 ± 14.7 mL/m<sup>2</sup>; p < 0.005) and larger indexed RV myocardial mass (58.2 [47.4-63.1] g/m<sup>2</sup> vs. 46.0 ± 12.9 g/m<sup>2</sup>; p = 0.013).</p><p><strong>Conclusion: </strong>Cardiac CT can be used to quantitatively evaluate RV remodeling after RV outflow tract reconstruction using a conduit patterns in patients with pulmonary atresia and ventricular septal defect. Echocardiography-derived pulmonary stenosis and elevated RV systolic pressure demonstrate significant correlations with the CT-derived parameters.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quantitative computed tomography assessment of right ventricular remodeling after right ventricular outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect: Correlations with echocardiographic parameters.\",\"authors\":\"Hyun Woo Goo\",\"doi\":\"10.1016/j.jcct.2025.05.236\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This retrospective study aimed to assess computed tomography (CT)-derived quantitative right ventricular (RV) remodeling patterns after RV outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect and correlate them with echocardiographic parameters.</p><p><strong>Methods: </strong>A total of 61 patients (90 CT volumetry studies, age: 16.2 ± 6.5 years) were retrospectively evaluated. Ventricular volume, myocardial mass, ejection fraction, stroke volume (SV), and SV difference were compared between the valveless and valved conduit groups; they were analyzed according to echocardiography-derived RV outflow tract pressure gradient and RV systolic pressure.</p><p><strong>Results: </strong>The valveless conduit group had smaller indexed left ventricular (LV) end-diastolic volume (83.4 ± 14.9 mL/m<sup>2</sup> [mean ± standard deviation] vs. 90.6 ± 17.6 mL/m<sup>2</sup>; p < 0.039) and indexed LV SV (43.0 ± 8.0 mL/m<sup>2</sup> vs. 48.0 ± 8.9 mL/m<sup>2</sup>; p < 0.006), larger indexed RV end-diastolic volume (118.0 ± 26.1 mL/m<sup>2</sup> vs. 98.1 [84.6-114.2] mL/m<sup>2</sup> [median {interquartile range}]; p = 0.010), indexed RV SV (62.5 ± 13.8 mL/m<sup>2</sup> vs. 49.3 ± 13.7 mL/m<sup>2</sup>; p < 0.001), and indexed SV difference (19.5 ± 12.3 mL/m<sup>2</sup> vs. -2.2 [-6.5-4.8] mL/m<sup>2</sup>; p < 0.001), and higher RV ejection fraction (53.2 ± 7.9 % vs. 48.7 [42.5-54.8]%; p = 0.018) than the valved conduit group. The moderate or severe pulmonary stenosis group had higher indexed RV myocardial mass (54.03 ± 15.1 g/m<sup>2</sup> vs. 43.8 [34.4-52.2] g/m<sup>2</sup>; p = 0.012); the moderately or severely elevated RV systolic pressure group had smaller indexed RV SV (53.4 ± 16.5 mL/m<sup>2</sup> vs. 62.8 ± 15.1 mL/m<sup>2</sup>; p < 0.032) and indexed SV difference (7.0 ± 14.7 mL/m<sup>2</sup> vs. 18.8 ± 14.7 mL/m<sup>2</sup>; p < 0.005) and larger indexed RV myocardial mass (58.2 [47.4-63.1] g/m<sup>2</sup> vs. 46.0 ± 12.9 g/m<sup>2</sup>; p = 0.013).</p><p><strong>Conclusion: </strong>Cardiac CT can be used to quantitatively evaluate RV remodeling after RV outflow tract reconstruction using a conduit patterns in patients with pulmonary atresia and ventricular septal defect. Echocardiography-derived pulmonary stenosis and elevated RV systolic pressure demonstrate significant correlations with the CT-derived parameters.</p>\",\"PeriodicalId\":94071,\"journal\":{\"name\":\"Journal of cardiovascular computed tomography\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiovascular computed tomography\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jcct.2025.05.236\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiovascular computed tomography","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jcct.2025.05.236","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：本回顾性研究旨在评估肺动脉闭锁和室间隔缺损患者经导管重建右心室流出道后，计算机断层扫描（CT）衍生的定量右心室重构模式，并将其与超声心动图参数相关联。方法：回顾性分析61例患者（90例CT容积检查，年龄：16.2±6.5岁）。比较无瓣膜组和有瓣膜导管组的心室容积、心肌质量、射血分数、卒中容积（SV）及SV差异；根据超声心动图得出的左室流出道压力梯度和右室收缩压进行分析。结果：无瓣膜导管组左室舒张末期指数容积较小(83.4±14.9 mL/m2[平均值±标准差]vs. 90.6±17.6 mL/m2；p < 0.039)，指标LV SV(43.0±8.0 mL/m2 vs. 48.0±8.9 mL/m2；p < 0.006)，指标心室舒张末期容积较大(118.0±26.1 mL/m2 vs. 98.1 [84.6-114.2] mL/m2[中位数{四分位数间距}]；p = 0.010),索引房车SV(62.5±13.8毫升/ m2与49.3±13.7毫升/平方米;p < 0.001)，指标SV差异(19.5±12.3 mL/m2 vs. -2.2 [-6.5-4.8] mL/m2；p < 0.001)，右心室射血分数较高(53.2±7.9% vs. 48.7% [42.5- 54.8%]%；P = 0.018)。中度或重度肺狭窄组右心室心肌质量指数较高(54.03±15.1 g/m2 vs. 43.8 [34.4-52.2] g/m2；P = 0.012)；中重度右室收缩压升高组右室SV指数较小（53.4±16.5 mL/m2 vs. 62.8±15.1 mL/m2）；p < 0.032)，指标SV差异(7.0±14.7 mL/m2 vs. 18.8±14.7 mL/m2；p < 0.005)，指标心室心肌质量较大(58.2 [47.4-63.1]g/m2 vs. 46.0±12.9 g/m2；P = 0.013)。结论：心脏CT可定量评价肺动脉闭锁室间隔缺损患者右心室流出道导管重建后右心室重构情况。超声心动图衍生的肺动脉狭窄和左室收缩压升高与ct衍生的参数有显著相关性。
Quantitative computed tomography assessment of right ventricular remodeling after right ventricular outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect: Correlations with echocardiographic parameters.
Background: This retrospective study aimed to assess computed tomography (CT)-derived quantitative right ventricular (RV) remodeling patterns after RV outflow tract reconstruction using a conduit in patients with pulmonary atresia and ventricular septal defect and correlate them with echocardiographic parameters.
Methods: A total of 61 patients (90 CT volumetry studies, age: 16.2 ± 6.5 years) were retrospectively evaluated. Ventricular volume, myocardial mass, ejection fraction, stroke volume (SV), and SV difference were compared between the valveless and valved conduit groups; they were analyzed according to echocardiography-derived RV outflow tract pressure gradient and RV systolic pressure.
Results: The valveless conduit group had smaller indexed left ventricular (LV) end-diastolic volume (83.4 ± 14.9 mL/m2 [mean ± standard deviation] vs. 90.6 ± 17.6 mL/m2; p < 0.039) and indexed LV SV (43.0 ± 8.0 mL/m2 vs. 48.0 ± 8.9 mL/m2; p < 0.006), larger indexed RV end-diastolic volume (118.0 ± 26.1 mL/m2 vs. 98.1 [84.6-114.2] mL/m2 [median {interquartile range}]; p = 0.010), indexed RV SV (62.5 ± 13.8 mL/m2 vs. 49.3 ± 13.7 mL/m2; p < 0.001), and indexed SV difference (19.5 ± 12.3 mL/m2 vs. -2.2 [-6.5-4.8] mL/m2; p < 0.001), and higher RV ejection fraction (53.2 ± 7.9 % vs. 48.7 [42.5-54.8]%; p = 0.018) than the valved conduit group. The moderate or severe pulmonary stenosis group had higher indexed RV myocardial mass (54.03 ± 15.1 g/m2 vs. 43.8 [34.4-52.2] g/m2; p = 0.012); the moderately or severely elevated RV systolic pressure group had smaller indexed RV SV (53.4 ± 16.5 mL/m2 vs. 62.8 ± 15.1 mL/m2; p < 0.032) and indexed SV difference (7.0 ± 14.7 mL/m2 vs. 18.8 ± 14.7 mL/m2; p < 0.005) and larger indexed RV myocardial mass (58.2 [47.4-63.1] g/m2 vs. 46.0 ± 12.9 g/m2; p = 0.013).
Conclusion: Cardiac CT can be used to quantitatively evaluate RV remodeling after RV outflow tract reconstruction using a conduit patterns in patients with pulmonary atresia and ventricular septal defect. Echocardiography-derived pulmonary stenosis and elevated RV systolic pressure demonstrate significant correlations with the CT-derived parameters.
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