| 徐家宜,袁新春,胡佳,张哲元,冉洪玲,杨昆,夏侯宇.无创右心室压力-应变环定量评估肝硬化患者TIPS前、后右心室心肌功能变化[J].中国医学影像技术,2025,41(9):1512~1516 |
| 无创右心室压力-应变环定量评估肝硬化患者TIPS前、后右心室心肌功能变化 |
| Noninvasive right ventricular pressure-strain loop for quantitative evaluation on right ventricular myocardial function changes in liver cirrhosis patients after TIPS |
| 投稿时间：2024-12-27 修订日期：2025-06-02 |
| DOI：10.13929/j.issn.1003-3289.2025.09.012 |
| 中文关键词: 肝硬化|门体分流术,经颈静脉肝内|心室压力|心室功能,右|超声心动描记术 |
| 英文关键词:liver cirrhosis|portosystemic shunt, transjugular intrahepatic|ventricular pressure|ventricular function, right|echocardiography |
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| 中文摘要: |
| 目的 观察无创右心室压力-应变环(RVPSL)用于定量评估肝硬化患者接受TIPS后右心室心肌功能变化的价值。方法 前瞻性纳入26例拟接受TIPS的肝硬化患者(肝硬化组),分别于TIPS前及其后1周、1个月行超声心动图检查,获取右心室常规超声心动图参数、右心室应变参数及右心室心肌做功参数;同期纳入30名健康成人作为对照组,记录上述右心室超声心动图参数。比较组间及肝硬化组内TIPS前、后上述参数,评估肝硬化组TIPS后右心室心肌功能变化。结果 各时间点肝硬化组右心室整体做功指数(RVGWI)、右心室整体有效功(RVGCW)及右心室整体无效功(RVGWW)均高于对照组(P均＜0.05)。TIPS后1周及1个月,肝硬化组右心室整体纵向应变(RVGLS)及右心室游离壁纵向应变(RVFWLS)均高于对照组(P均＜0.05)。肝硬化组内,TIPS后1周RVGWI、RVGCW及RVGWW均高于TIPS前及TIPS后1个月(P均＜0.05),TIPS后1周RVGLS、TIPS后1个月RVGWI均高于TIPS前(P均＜0.05)。结论 无创RVPSL能较为敏感地定量评估肝硬化患者TIPS后右心室功能变化。 |
| 英文摘要: |
| Objective To observe the value of noninvasive right ventricular pressure-strain loop (RVPSL) for quantitative evaluation on right ventricular myocardial function changes in liver cirrhosis patients after TIPS. Methods Totally 26 cases of liver cirrhosis who would undergo TIPS were prospectively recruited as liver cirrhosis group. Echocardiography was performed before and 1 week, 1 month after TIPS, and parameters of right ventricular myocardial function, including routine right ventricular echocardiography, right ventricular strain and right ventricular myocardial work were acquired. Meanwhile, 30 healthy adults were recruited as control group, and the above parameters were recorded. Then these parameters were compared between groups, also before and after TIPS within liver cirrhosis group, and the changes of right ventricular myocardial function after TIPS were evaluated. Results Right ventricular global work index (RVGWI), right ventricular global constructive work (RVGCW) and right ventricular global wasted work (RVGWW) in liver cirrhosis group were higher than those in control group at all time points (all P＜0.05). One weak and 1 month after TIPS, right ventricular global longitudinal strain (RVGLS) and right ventricular free wall longitudinal strain (RVFWLS) in liver cirrhosis group were all higher than those in control group (all P＜0.05). In liver cirrhosis group, RVGWI, RVGCW and RVGWW 1 week after TIPS were all higher than those before TIPS and 1 month after TIPS (all P＜0.05), while RVGLS 1 weak and RVGWI 1 month after TIPS were both higher than those before TIPS (both P＜0.05). Conclusion Noninvasive RVPSL could be used to sensitively and quantitatively evaluate right ventricular function changes in patients with liver cirrhosis after TIPS. |
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