右心室Tei指数监测肺动脉血栓内膜剥脱术前后患者血流动力学变化

Utility of tissue Doppler right ventricular Tei index in the evaluation of chronic thromboembolic pulmonary hypertension hemodynamics before and after pulmonary thromboendarterectomy

目的应用右心室Tei指数监测肺动脉血栓内膜剥脱术（PEA）前后患者血流动力学改变情况,评价其临床应用价值。方法慢性血栓栓塞性肺动脉高压（CTEPH）患者23例,其中男性19例,女性4例;年龄17~64岁,平均年龄44.5岁。于PEA术前及术后3个月分别测量右心室Tei指数,并与对应检查时间点右心导管测量的肺动脉平均压（mPAP）、肺血管阻力（PVR）及右心排血量（RCO）间做相关性分析。结果 PEA术前患者右心室Tei指数增大（0.82±0.25）,术后3个月超声心动图测量右心室Tei指数较术前明显减小（0.48±0.30;P〈0.01）。右心室Tei指数与PVR之间呈正相关（P〈0.001）,与mPAP及RCO之间具有相关性（P〈0.05）。结论可以应用右心室Tei指数这一无创性检查参数监测PEA术前及术后CTEPH患者血流动力学改变情况。

Objective To evaluate the utility of tissue Doppler-derived right ventricular（RV） Tei index in patients with chronic thromboembolic pulmonary hypertension（CTEPH） before and after pulmonary thromboendarterectomy（PEA）. Methods A total of23 patients with CTEPH were enrolled, which included 19 males and 4 females; aged 17- 64 years old with mean age of 44.5.The tissue Doppler-derived RV Tei index was measured before and after PEA, and assessed correlations with mean pulmonary artery pressure（mPAP）, pulmonary vascular resistance（PVR）, and right cardiac output（RCO） by right heart catheterization. Results The Tei index of RV before PEA surgery was（0.82 ± 0.25） and significant decreased to（0.48 ± 0.30, P ＆lt; 0.01） after PEA surgery 3-month by echocardiography. The RV Tei index correlated with PVR before and after surgery（P ＆lt; 0.001）. RV Tei index also correlated with mPAP or RCO（P ＆lt; 0.05）. Conclusion It is demonstrated that the RV Tei index could be the valuable noninvasive parameter for monitoring disease severity in CTEPH and outcomes after PEA.