肺高血压之右心功能评估

Assessment of right heart function in pulmonary hypertension

肺高血压是一种预后差的严重疾病,可发展为右心衰竭,进而导致死亡。及时、准确地评估右心功能对于判断疾病严重程度、制定治疗方案以及对疾病预后的评估有重要意义。该文对目前常用的评价右心功能的检查技术、指标及临床意义进行介绍,包括心电图、超声心动图、心脏磁共振、电子计算机断层扫描等。超声心动图是重要的筛查手段,通过三尖瓣环收缩期位移幅度(TAPSE)、右室心肌做功指数(RIMP)、面积变化分数(FAC)等指标可较为准确地反映右心功能,心脏磁共振是无创评估右心功能的金标准,电子计算机断层扫描技术除可反映右心功能外,还能反映胸腔内其他结构,有助于寻找导致肺高血压的病因。

Pulmonary hypertension is a serious disease with poor prognosis,which can develop into right heart failure,and lead to death.Timely and accurate assessment of right heart function is of great significance for judging the severity of the disease,making treatment plans and assessing the prognosis of the disease.In this review,the commonly used examination techniques,indicators and clinical significance of right heart function assessment are introduced,including electrocardiogram,echocardiography,cardiac magnetic resonance,computed tomography scanning,etc.Echocardiography is an important screening method.Tricuspid annular plane systolic excursion(TAPSE),right ventricular index of myocardial performance(RIMP)and fractional area change(FAC)can reflect the right heart function more accurately.Cardiac magnetic resonance is the gold standard for noninvasive assessment of right heart function.Computed tomography scanning technology can reflect not only the right heart function,but also other structures in the chest,which is helpful to find the causes of pulmonary hypertension.