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中华医学超声杂志(电子版) ›› 2022, Vol. 19 ›› Issue (10) : 1122 -1126. doi: 10.3877/cma.j.issn.1672-6448.2022.10.018

综述

超声心动图评价右心室-肺动脉耦联的研究进展
孟庆龙1, 王浩1,()   
  1. 1. 北京协和医学院 中国医学科学院 阜外医院超声影像中心
  • 收稿日期:2021-04-11 出版日期:2022-10-01
  • 通信作者: 王浩

Progress in echocardiography evaluation of right ventricular-pulmonary arterial coupling

Qinglong Meng1, Hao Wang1()   

  • Received:2021-04-11 Published:2022-10-01
  • Corresponding author: Hao Wang
引用本文:

孟庆龙, 王浩. 超声心动图评价右心室-肺动脉耦联的研究进展[J]. 中华医学超声杂志(电子版), 2022, 19(10): 1122-1126.

Qinglong Meng, Hao Wang. Progress in echocardiography evaluation of right ventricular-pulmonary arterial coupling[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(10): 1122-1126.

图1 右心室-肺动脉耦联的心导管评估方法。图a显示改变右心室前负荷后所得到的不同前负荷条件下的压力-容积曲线,每条曲线的收缩末期点形成右心室收缩末期压力容积关系线(ESPVR),其斜率即代表收缩末期弹性(Ees);图b显示在不改变前负荷的条件下,单个心动周期的压力-容积曲线(图中黑色闭环实线)中收缩末期点与舒张末期点连接形成的直线的斜率即有效动脉弹性(Ea),此时两条直线交汇点(Ees/Ea)即表征右心室-肺动脉耦联[图片改自:Ikonomidis I, Aboyans V, Blacher J, et al. The role of ventricular-arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association. Eur J Heart Fail, 2019, 21(4): 402-424.]注:1 mmHg=0.133 kPa
图2 三尖瓣环收缩期位移与肺动脉收缩压比值(TAPSE/PASP)的超声获取方法。图中显示TAPSE/PASP的获取方法,即分别获得心尖四腔心切面的TAPSE以及三尖瓣反流的最大压差,通过估算右心房压力以间接计算PASP
图3 每搏量与收缩末期容积比值(SV/ESV)的超声获取方法。图中显示利用三维超声计算SV/ESV的方法,首先获取聚焦右心室的三维Full Volume图像,随后利用分析软件勾画右心室形态,计算收缩末期容积及每搏量
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