肺栓塞患者右心室心肌整体纵向应变评价右心室功能。

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2025-08-06 DOI:10.18087/cardio.2025.7.n2860

Xinyan Qi, Liu Jun, Dongmei Wang, Houqiang Zhou

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Clinical data and RV function-related variables of these groups were compared.Results Compared with pre-treatment values of Group A, the following variables of Groups B and C had higher pre-treatment values (p<0.05): RV end-diastolic diameter (RVEDD), RV to left ventricular diameter ratio (RV / LV), RV work index (RIMP), main pulmonary artery diameter (MPA), pulmonary artery systolic pressure (PASP), RVGLS, RV free wall longitudinal strain (RVFWLS),The following variables had lower values (p<0.05): RV area change fraction (RVFAC), RV ejection fraction (RVEF), RV short-axis shortening rate (RVFS), tricuspid annular peak systolic velocity (S'), tricuspid annular systolic excursion (TAPSE). After therapy, significant differences were observed in the aforementioned indicators between Group C (with pulmonary hypertension) and Group A (healthy controls), with Group C showing persistently elevated RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, alongside reduced RVFAC, RVEF, RVFS, S', and TAPSE compared to Group A (all p<0.05). Compared to pre-treatment values in Group B (without pulmonary hypertension), pre-treatment Group C demonstrated significantly higher RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, and significantly lower RVFAC, RVEF, RVFS, S', and TAPSE (all p<0.05). Post-treatment comparisons between Groups B and C revealed that these differences remained significant (all p<0.05). ROC curve analysis revealed that RVGLS> 20.59 % is the best cutoff value for predicting the occurrence of pulmonary embolism, and RVGLS> -17.42 % is the best cutoff value for predicting the occurrence of pulmonary hypertension in patients withpulmonary embolism. The results of multivariable logistic regression model analysis showed that RVGLS>-20.59 % is independently related to the occurrence of pulmonary embolism, and RVGLS>-17.42 % is independently related to pulmonary embolism complicated by pulmonary hypertension (p<0.05). In Groups A and B, RVGLS was negatively correlated with RVFAC, RVEF, and TAPSE (p<0.05 for all) and positively correlated with RIMP and PASP (p<0.05 for all). In Groups B and C, RVGLS was negatively correlated with RVFAC and RVEF in patients with pulmonary embolism before and after treatment (for all <0.05) and positively correlated with RIMP and PASP (p<0.05 for all).Conclusion RVGLS can be applied to evaluate the RV function of patients with pulmonary embolism. 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引用次数: 0

摘要

目的探讨右心室（RV）心肌总纵应变（RVGLS）在评估肺栓塞患者右心室功能变化中的临床应用价值。材料与方法选取2022年1月至2023年12月在我院治疗成功的肺栓塞患者为研究对象。包括34名无肺动脉高压的肺栓塞患者（B组），31名肺动脉高压患者（C组）和35名按性别和年龄匹配的健康志愿者（A组）。比较两组临床资料及左心室功能相关变量。结果与A组相比，B、C组左室舒张末期内径（RVEDD）、左室与左室内径比（RV / LV）、左室工作指数（RIMP）、肺动脉主干内径（MPA）、肺动脉收缩压（PASP）、RVGLS、右室自由壁纵向应变（RVFWLS）预处理值较高（p<0.05），左室自由壁纵向应变值较低（p<0.05）；右心室面积变化分数（RVFAC）、右心室射血分数（RVEF）、右心室短轴缩短率（RVFS）、三尖瓣环状峰值收缩速度（S’）、三尖瓣环状收缩偏移（TAPSE）。治疗后，C组（合并肺动脉高压）与A组（健康对照组）上述指标均有显著差异，其中C组RVEDD、RV / LV比值、RIMP、MPA、PASP、RVGLS、RVFWLS持续升高，RVFAC、RVEF、RVFS、S′、TAPSE均较A组降低（p < 0.05）。与B组（无肺动脉高压）治疗前相比，C组治疗前RVEDD、RV / LV比值、RIMP、MPA、PASP、RVGLS、RVFWLS显著升高，RVFAC、RVEF、RVFS、S′、TAPSE显著降低（p < 0.05）。B组和C组治疗后比较显示，这些差异仍然显著（p < 0.05）。ROC曲线分析显示，RVGLS>；预测肺栓塞发生的最佳临界值为20.59%,RVGLS>；- 17.42%是预测肺栓塞患者肺动脉高压发生的最佳临界值。多变量logistic回归模型分析结果显示，RVGLS>- 20.59%与肺栓塞发生独立相关，RVGLS>- 17.42%与肺栓塞合并肺动脉高压独立相关（p<0.05）。A、B组RVGLS与RVFAC、RVEF、TAPSE呈负相关（p < 0.05），与RIMP、PASP呈正相关（p < 0.05）。B、C组肺栓塞患者治疗前后RVGLS与RVFAC、RVEF呈负相关（p < 0.05），与RIMP、PASP呈正相关（p < 0.05）。结论RVGLS可用于评价肺栓塞患者的右心室功能。RVGLS>- 20.59%与肺栓塞独立相关，治疗前后肺栓塞患者RVGLS与RVVFAC、RVEF、RIMP、PASP有显著相关性。

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Right Ventricular Myocardial Global Longitudinal Strain Assessment of Right Ventricular Function in Patients with Pulmonary Embolism.

Objective To explore the clinical application value of right ventricular (RV) myocardial global longitudinal strain(RVGLS) in assessing changes in RV function in patients with pulmonary embolism.Material and methods Patients with pulmonary embolism who were treated successfully in our hospital from January 2022 toDecember 2023 were enrolled in this study. Included were 34 pulmonary embolism patients without pulmonary hypertension (Group B), 31 with pulmonary hypertension (Group C), and 35 healthy volunteers, matched by gender and age (Group A). Clinical data and RV function-related variables of these groups were compared.Results Compared with pre-treatment values of Group A, the following variables of Groups B and C had higher pre-treatment values (p<0.05): RV end-diastolic diameter (RVEDD), RV to left ventricular diameter ratio (RV / LV), RV work index (RIMP), main pulmonary artery diameter (MPA), pulmonary artery systolic pressure (PASP), RVGLS, RV free wall longitudinal strain (RVFWLS),The following variables had lower values (p<0.05): RV area change fraction (RVFAC), RV ejection fraction (RVEF), RV short-axis shortening rate (RVFS), tricuspid annular peak systolic velocity (S'), tricuspid annular systolic excursion (TAPSE). After therapy, significant differences were observed in the aforementioned indicators between Group C (with pulmonary hypertension) and Group A (healthy controls), with Group C showing persistently elevated RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, alongside reduced RVFAC, RVEF, RVFS, S', and TAPSE compared to Group A (all p<0.05). Compared to pre-treatment values in Group B (without pulmonary hypertension), pre-treatment Group C demonstrated significantly higher RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, and significantly lower RVFAC, RVEF, RVFS, S', and TAPSE (all p<0.05). Post-treatment comparisons between Groups B and C revealed that these differences remained significant (all p<0.05). ROC curve analysis revealed that RVGLS> 20.59 % is the best cutoff value for predicting the occurrence of pulmonary embolism, and RVGLS> -17.42 % is the best cutoff value for predicting the occurrence of pulmonary hypertension in patients withpulmonary embolism. The results of multivariable logistic regression model analysis showed that RVGLS>-20.59 % is independently related to the occurrence of pulmonary embolism, and RVGLS>-17.42 % is independently related to pulmonary embolism complicated by pulmonary hypertension (p<0.05). In Groups A and B, RVGLS was negatively correlated with RVFAC, RVEF, and TAPSE (p<0.05 for all) and positively correlated with RIMP and PASP (p<0.05 for all). In Groups B and C, RVGLS was negatively correlated with RVFAC and RVEF in patients with pulmonary embolism before and after treatment (for all <0.05) and positively correlated with RIMP and PASP (p<0.05 for all).Conclusion RVGLS can be applied to evaluate the RV function of patients with pulmonary embolism. RVGLS>-20.59 % is independently related to pulmonary embolism, and there is a significant correlation between RVGLS and RVVFAC, RVEF, RIMP, and PASP in patients with pulmonary embolism before and after treatment.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.