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Preserved right ventricular function but increased right atrial contractile demand in altitude-induced pulmonary hypertension.

在高原诱导的肺动脉高压中保留右心室功能但增加右心房收缩需求。

  • 影响因子:1.76
  • DOI:10.1007/s10554-020-01803-x
  • 作者列表:"Sareban M","Perz T","Macholz F","Reich B","Schmidt P","Fried S","Mairbäurl H","Berger MM","Niebauer J
  • 发表时间:2020-06-01
Abstract

PURPOSE:Ascent to high altitude increases right ventricular (RV) afterload and decreases myocardial energy supply. This study evaluates physiologic variables and comprehensive echocardiographic indices of RV and right atrial (RA) function following rapid ascent to high altitude. METHODS:Fifty healthy volunteers actively ascended from 1130 to 4559 m in < 22 h. All participants underwent 2D echocardiography during baseline examination at low altitude (424 m) and at three study time-points (7, 20 and 44 h) after arrival at high altitude. In addition to systolic pulmonary artery pressure (sPAP), comprehensive 2D planimetric-, tissue Doppler- and speckle-tracking-derived strain indices of RA and RV function were obtained. RESULTS:sPAP increased from baseline (24 ± 4 mmHg) to the first altitude examination (39 ± 8 mmHg, p < 0.001) and remained elevated during the following 44 h. Global RV function did not change. RA reservoir strain showed a trend towards increase from baseline (50.2 ± 12.1%) to the first altitude examination (53.8 ± 11.0%, p = 0.07) secondary to a significant increase of RA contraction strain (19.2 ± 6.4 vs. 25.4 ± 9.6%, p < 0.001). Volumetric RA data largely paralleled RA strain results and RA active emptying volume was increased throughout the 44 h stay at high altitude. CONCLUSION:Active and rapid ascent of healthy individuals to 4559 m is associated with an increased contractile performance of the RA that compensates for the increased workload of the RV.

摘要

目的: 上升到高海拔增加右心室后负荷,降低心肌能量供应。本研究评估了快速上升到高原后RV和右心房 (RA) 功能的生理变量和综合超声心动图指标。 方法: 50名健康志愿者在 <22小时内从1130米上升到4559米。所有参与者在低海拔 (424米) 基线检查期间和到达高海拔后的三个研究时间点 (7、20和44小时) 进行二维超声心动图检查。除肺动脉收缩压 (sPAP) 外,还获得了全面的二维平面测量、组织多普勒和斑点追踪衍生的RA应变指数和RV功能指数。 结果: sPAP从基线 (24 ± 4 mmHg) 增加到第一次高原检查 (39 ± 8 mmHg,p <0.001),并在随后的44小时内保持升高。全局RV功能没有改变。RA储层应变显示出从基线 (50.2 ± 12.1%) 到第一次海拔检查 (53.8 ± 11.0%,p = 0.07) 的增加趋势,继发于RA收缩应变的显著增加 (19.2 ± 6.4 vs. 25.4 ± 9.6%,p <0.001)。体积RA数据在很大程度上与RA应变结果平行,RA主动排空体积在高海拔停留44小时内增加。 结论: 健康个体的积极和快速上升到4559 m与RA的收缩性能增加相关,这补偿了RV的增加的工作负荷。

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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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