The conservative therapy of heart failure improves pulmonary hypertension in dilated cardiomyopathy with the evaluation of echocardiographic strain imaging
LI Pu-nan, ZHANG Xiao-li, ZHAO Jia, SHEN Xi-ling, TIAN Kun, LI Qing-feng
Department of Ultrasound, Jincheng People’s Hospital, Jincheng Shanxi 048000, China
Abstract：Objective: The aim of the study was to investigate the effect of conservative therapy on pulmonary hypertension(PH) and right ventricular(RV) function in DCM. Methods: This is a retrospective analysis of 60 consecutive DCM patients with evaluation of echocardiographic pulmonary artery systolic pressure(PASP) and right ventricular strain. Results: Compared with patients without PH, patients with PH(PASP≥35 mmHg) had worse left systolic and diastolic function. The ejection fraction increased post-therapy(P=0.046). Reduction of PASP post-therapy was evident in patients with PH(P＜0.001). The tricuspid annular plane systolic excursion(TAPSE) showed no significant difference post-therapy(P=0.102), however, the increase of the RV free wall strain was demonstrated post-therapy with strain imaging(P＜0.001). Compared with TAPSE, the correlation between RV free wall strain and right ventricular ejection fraction(magnetic resonance imaging) was better(r=0.808, P=0.008). Conclusion: The results of this study support the potential of strain imaging to estimate RV function, and adding significant value to conventional echocardiographic measurements.
李普楠，张小丽，赵 嘉，申喜玲，田 坤，李庆峰. 超声应变分析扩张型心肌病治疗前后肺动脉压力和右心功能改变[J]. 中国临床医学影像杂志, 2020, 31(5): 334-337.
LI Pu-nan, ZHANG Xiao-li, ZHAO Jia, SHEN Xi-ling, TIAN Kun, LI Qing-feng. The conservative therapy of heart failure improves pulmonary hypertension in dilated cardiomyopathy with the evaluation of echocardiographic strain imaging. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(5): 334-337.
[1]Dec GW, Fuster V. Idiopathic dilated cardiomyopathy[J]. New Engl J Med, 1994, 331: 1564-1575.
[2]中华医学会心血管病学分会等. 中国心力衰竭诊断和治疗指南[J]. 中华心血管病杂志，2014，42（2）：98-122.
[3]Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the american society of echocardiography and the European association of cardiovascular imaging[J]. J Am Soc Echocardiogr, 2015, 8: 1-39e.
[4]Motoki H, Borowski AG, Shrestha K, et al. Right ventricular global longitudinal strain provides prognostic value incremental to left ventricular ejection fraction in patients with heart failure[J]. J Am Soc Echocardiogr, 2014, 27: 726-732.
[5]Hart SA, Krasuski RA, Wang A, et al. Pulmonary hypertension and elevated transpulmonary gradient in patients with mitral stenosis[J]. J Heart Valve Dis, 2010, 19: 708-715.
[6]Giusca S, Dambrauskaite V, Scheurwegs C, et al. Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring[J]. Heart, 2010, 96: 281-288.
[7]张颖雪，赵新湘. 扩张型心肌病做新结构功能心脏核磁共振评价与NT-proBNP相关性研究[J]. 中国临床医学影像杂志，2018，29（6）：404-408.
2020, Vol. 31 
