超声及右室定量系统与右心导管评价肺动脉高压患者右室功能间的相关性

Correlation between echocardiography,right ventricular quantitative system and right heart catheter evaluation of right ventricular function in patients with pulmonary hypertension

目的探讨超声、右室定量系统与右心导管评估肺动脉高压患者右室收缩功能间相关性。方法回顾性纳入2022年8月~2023年5月就诊于中国科学技术大学附属第一医院(安徽省立医院)的22例肺动脉高压患者,均接受超声、右心定量系统及右心导管检查,分析传统超声参数、右室定量系统参数及右心导管参数之间的相关性,包括三尖瓣外侧瓣环运动位移(TAPSE)、三尖瓣外侧瓣环运动速度(TASPV)、右室面积变化分数(RVFAC)、右室射血分数(RVEF)、右室心输出量(RVCO)以及导管热稀释法测量右室的心输出量(TDCO)。结果TAPSE与RVCO、RVEF呈正相关(r=0.698、0.678,P<0.01);TASPV与RVCO、RVEF呈正相关(r=0.451、0.507,P<0.05);RVFAC与RVEF呈正相关(r=0.971,P<0.01);TAPSE与TDCO呈正相关(r=0.680,P<0.01);TASPV、RVFAC与TDCO无相关性。RVCO与TDCO呈正相关(r=0.918,P<0.01);Bland-Altman散点图显示RVCO与TDCO差值均值为-0.198 L/min(95%CI:-1.29~0.89 L/min,P>0.05),两种测量方法一致性高。结论右室定量系统与导管评估右室收缩功能具有良好相关性,二者在测量心输出量上无明显差异,右室定量系统可以作为无创评估右室功能新方法。

Objective To explore the correlation between ultrasound,right ventricular quantitative system and right heart catheterization in evaluating right ventricular systolic function in patients with pulmonary hypertension.Methods Twenty-two patients with pulmonary hypertension hospitalized in the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from August 2022 to May 2023 were enrolled in this retrospective analysis.These patients all accepted examinations of ultrasound,right heart quantitative system and right heart catheterization.The correlation between traditional ultrasound parameters,right ventricular quantitative system parameters and right heart catheterization parameters were analyzed,including lateral tricuspid annulus displacement(TAPSE),lateral tricuspid annulus velocity(TASPV)and right ventricular area change fraction(RVFAC),right ventricular ejection fraction(RVEF)and right ventricular cardiac output(RVCO),cardiac output measured by thermodilution(TDCO).Results TAPSE was positively correlated with RVCO and RVEF(r=0.698,0.678,P<0.01),TASPV was positively correlated with RVCO and RVEF(r=0.451,0.507,P<0.05),RVFAC was significantly positively correlated with RVEF(r=0.971,P<0.01);TAPSE was positively correlated with TDCO(r=0.680,P<0.01).There was no correlation between TASPV,RVFAC and TDCO.RVCO was significantly positively correlated with TDCO(r=0.918,P<0.01).The Bland Altman scatter plot showed that the mean difference between RVCO and TDCO was-0.198 L/min(95%CI:-1.29-0.89 L/min,P>0.05),indicating the high consistency between the two measurement methods.Conclusion Right ventricular quantitative system and right cardiac catheter have good correlation in evaluating right ventricular systolic function and there is no significant difference in measuring cardiac output between them.Right ventricular quantitative system can be used as a new non-invasive method for evaluating right ventricular function.