Tải xuống
Tóm tắt
Objectives: To determine pulmonary vascular resistance (PVR) by echocardiography - Doppler; and evaluate the correlation between pulmonary vascular resistance and some variables such as left ventricular EF, PASP, TAPSE, and tissue S-wave of the tricuspid valve in patients with ischemic heart disease.
Method: Observational study on 82 heart failure patients with reduce ejection fraction brought upon by ischemic heart disease, at the Cardiology Department of the University of Medicine and Pharmacy from 04/2016 - 05/2017.
Results: The average PVR is 3.91 ± 1.85 WU. There was not significant difference between age and gender groups (p > 0.05), but there was a statistically significant difference of PVR in patients with NYHA III and IV compared to NYHA I, II (p < 0.05). When EF < 30%, the rate of increased PVR is higher than the normal value (35.4 % vs 4.9%). There is a strong correlation between LVEF and PVR (r = - 0.545, p < 0.001), especially when PVR < 8 WU (r = - 0.618, p < 0.001). When the PASP increases, the rate of increased PVR is higher than normal value (54.9% vs. 9.8%, p < 0.001), with an enough correlation coefficient (r = 0.361, p < 0.001). In patients with RV systolic dysfunction evaluated by TAPSE and S’ wave, there was a significant difference in the rate of increased PVR from the normal value (41.5% vs 1.2%; 34.1 vs 8.5%, p 0.001). PVR is closely correlated with TAPSE (r = -0.590; p < 0.001) and is inversely correlated with S’ wave (r = -0.590; p < 0.001).
Conclusions: Increased PVR is the primary mechanism for pulmonary hypertension and right ventricular dysfunction in patients with HFrEF brought upon by IHD. The evaluation of PVR in patients with left ventricular dysfunction by echocardiography is important in clinical practice.
Tài liệu tham khảo
Dini FL, Pugliese NR, Ameri P, Attanasio U, Badagliacca R, Correale M, et al. Right ventricular failure in left heart disease: from pathophysiology to clinical manifestations and prognosis. Heart Fail Rev. 2023;28(4):757-766.
Nguyen Quang Tuan. Stable coronary disease in 100 things to know about stable coronary disease. 2014, Medical Publishing House. 22-24, 55, 62-67, 93-101.
Nguyen Thi Mai Ngoc. Evaluation of pulmonary artery resistance by ultrasound Doppler before and after treatment to close the Atrial septal defect. Hanoi Medical University. 2011.
Nga Pham Thi Tuyet Nga. Study of pulmonary vascular resistance in patients with mitral stenosis before and after balloon angioplasty. Hanoi Medical University. 2013.
Vuong Pham Tan Vuong. Study of pulmonary vascular resistance by Doppler echocardiography in patients with mitral stenosis. 2015, Hue University of Medicine and Pharmacy.
Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117(11):1436-48.
Lankhaar JW, Westerhof N, Faes TJ, Gan CT, Marques KM, Boonstra A, et al. Pulmonary vascular resistance and compliance stay inversely related during treatment of pulmonary hypertension. Eur Heart J. 2008;29(13):1688-95.
Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, et al. Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute working group on cellular and molecular mechanisms of right heart failure. Circulation. 2006;114(17):1883-91.
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, 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 Am Soc Echocardiogr. 2015;28(1):1-39.e14.
Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49-73.
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2016;37(27):2129-2200.
Abbas AE, Fortuin FD, Schiller NB, Appleton CP, Moreno CA, Lester SJ. A simple method for noninvasive estimation of pulmonary vascular resistance. J Am Coll Cardiol. 2003;41(6):1021-7.
Bursi F, McNallan SM, Redfield MM, Nkomo VT, Lam CS, Weston SA, et al. Pulmonary pressures and death in heart failure: a community study. J Am Coll Cardiol, 2012;59(3):222-31.
Schalla S, Jaarsma C, Bekkers SC, Waltenberger J, Dennert R, Crijns HJ, et al. Right ventricular function in dilated cardiomyopathy and ischemic heart disease: assessment with non-invasive imaging. Neth Heart J. 2015;23(4):232-40.
Fabregat-Andrés Ó, Estornell-Erill J, Ridocci-Soriano F, Pérez-Boscá JL, García-González P, Payá-Serrano R, et al. Prognostic Value of Pulmonary Vascular Resistance by Magnetic Resonance in Systolic Heart Failure. Arq Bras Cardiol. 2016;106(3):226-35.
Assadpour M, Piranfar MK. Correlation between pulmonary vascular resistance and some cardiac indices. Iranian Cardiovascular Research Journal. 2011;5(30):92-96.
| Đã xuất bản | 26-12-2024 | |
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| Số tạp chí | Số 92 (2023) | |
| Phân mục | Nghiên cứu | |
| DOI | 10.38103/jcmhch.92.14 | |
| Từ khóa | Pulmonary vascular resistance, echocardiography, heart failure, reduced ejection fraction. |
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