Assessment of the Right Ventricle By Echocardiography：超声心动图评价右心室.ppt

Tricuspid Annular Plane Systolic Excursion ※ TAPSE and RV ejection fraction : TAPSE 2cm = RVEF 50% : TAPSE 1.5cm = RVEF 40% : TAPSE 1cm = RVEF 30% : TAPSE 0.5cm = RVEF 20% Event free survival according to TAPSE in patients with CHF Doppler Echocardiography: Tissue Doppler Imaging Peak systolic velocity (PSV) Normal 11.5 Tricuspid lateral annular velocities nl- 10 cm/sec ICT IRT Doppler Echocardiography: Tissue Doppler Imaging ? Allows quantitative assessment of RV systolic and diastolic function by measurement of myocardial velocities ? Peak systolic velocity (PSV) : PSV 11.5 cm/s identifies the presence of RV dysfunction : Sensitivity of 90%, specificity of 85% : Less affected by HR, loading condition, and degree of TR ? Tricuspid lateral annular velocities : Reduced in patients with inferior MI and RV involvement : Associated with the severity of RV dysfunction in patients with heart failure Doppler Echocardiography: Strain Rate Imaging Doppler Echocardiography: Strain Rate Imaging Doppler Echocardiography: Strain Rate Imaging ? RV longitudinal strain in apical view : Feasible in clinical setting : Baso-apical gradient with higher velocities at the base : RV velocities are consistently higher as compared to LV ? Strain and strain rate values : More inhomogeneously distributed in the RV : Reverse baso-apical gradient, reaching the highest values in the apical segments and outflow tract ? Acute increase in RV afterload : Increase in RV myocardial strain rate : Decrease in peak systolic strain, indicating a decrease in SV Doppler Echocardiography: 3D Echocardiography ? Advantages of RT3DE : Volume analysis does not rely on geometric assumptions : Little artifacts associated with motion or respiration ? Multiple slices may be obtained from the base to the apex of the heart as in the method of discs : Measure entire RV volume : Well correlated with RV volume measured by MRI RV Function: 3D Echocardiography RV Function: