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英文誌(2004-)

Journal of Medical Ultrasonics

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2016 - Vol.43

Vol.43 No.Supplement

特別プログラム 循環器
シンポジウム 循環器 Joint(JSUM・AFSUMB Joint Session)(English) 右心・肺高血圧の評価における心エコー法の役割

(S270)

新しい右室全体機能指標としての3次元右室面積ストレインの意義

Right Ventricular Area Strain as the New Indicator for Global Right Ventricular Systolic Function

石津 智子1, 瀬尾 由広2, 町野 智子2, 山本 昌良2, 針村 佳江2, 青沼 和隆2

Tomoko ISHIZU1, Yoshihiro SEO2, Tomoko MACHINO-OHTSUKA2, Masayoshi YAMAMOTO2, Yoshie HARIMURA2, Kazutaka AONUMA2

1筑波大学臨床検査医学, 2筑波大学循環器内科

1Department of Clinical Laboratory Medicine, University of Tsukuba, 2Cardiovascular Division, University of Tsukuba

キーワード :

【Background】
While right ventricular(RV)systolic dysfunction is associated with the poor prognosis, the accurate assessments of global RV function at bedside is still difficult.
【Method and Results】
Among 144 subjects who underwent RV 3D echocardiography assessment, 90(63%)subjects(20 with pulmonary arterial hypertension, 22 with congenital heart disease, 24 dilated cardiomyopathy, and 24 normal subjects)with sufficient 3D image quality were included. Remaining 54(38%)subjects with the insufficient quality of echo image, mainly in RV outlet, were excluded. Prototype software for RV 3D speckle tracking(Toshiba Medical Systems)was used. In comparison to the RV ejection fraction(EF), significant correlations(p<0.001)were observed in following indices; TAPSE(R=0.47), fractional area change(FAC)(R=0.57), global area strain(R=-0.82), global longitudinal strain(R=-0.58), global circumferential strain(R=-0.52), but not in tissue Doppler S’of tricuspid annuls. In stepwise methods for RVEF determinants, global area strain was selected as the best indicator, followed by the area strain of RV inlet, and FAC. To diagnose RVEF<30%,inlet area strain>-27%showed the greatest area under the curve of 0.89(p<0.001)in ROC analysis with sensitivity of 80%,specificity of 79%among the all RV indices.
【Conclusion】
Area strain, derived from 3D speckle tracking echocardiography, may be the promising accurate indicator for RVEF among the various echocardiographic parameters.