| Objective The research aims to comprehensively assess right ventricular(RV) regional and global volume and function in patients with right coronary artery disease. This assessment is multi-index by using conventional echocardiography, real-time three-dimensional echocardiography(RT3DE)technology and Tom Tec 4D RV-function analysis software.Methods 20 normal control participants(Group A), 30 patients with right coronary artery stenosis(Group B) and 10 patients with RV myocardial infarction(Group C) were studied. Apply GE Vivid 7 Dimension Color Doppler ultrasound imaging device to inspect conventional echocardiography and RT3 DE with M3 S probe and 3V probe. After obtaining satisfactory apical four-chamber view of the right ventricle section, peak early diastolic tricuspid orifice velocity(E), peak late diastolic tricuspid orifice velocity(A), peak early diastolic tricuspid orifice velocity deceleration time(EDT), peak early diastolic tricuspid annular velocity(e′), peak late diastolic tricuspid annular velocity(a′), peak systolic tricuspid annular velocity(S′), right ventricular myocardial performance index(RVMPI), tricuspid annular plane systolic excursion(TAPSE), right ventricular end diastolic area(RVAd), right ventricular end systolic area(RVAs) were measured by using M3 S probe and full volume imaging of RV were imported to Tom Tec workstation, starting 4D RV-function analysis software, acquiring three regional(inflow, body, outflow)and global EDV, ESV, SV, EF. Compare and contrast the parameters among the three groups. The correlation between S′, RVMPI, TAPSE, RVFAC and 3D-RVEF was analyzed by using Pearson correlation analysis. RT3 DE quantitative analysis of the repeatability test was carried out at last.Results Compared with Group A and Group B, S ’, RVMPI, TAPSE and RVFAC were lower in Group C(P<0.05), but RVMPI was higher. There was no significant difference of S ’, RVMPI, TAPSE and RVFAC between group A and group B(P>0.05). E in Group B and Group C were lower than Group A, but A in Group B were higher than Group A, E/A was lower(P<0.05). There was no significant difference of e′, a′, E/e′, e′/a′ among the three groups(P>0.05). EDT in Group B was higher than Group A and Group C(P<0.05), but there was no significant difference of that between group A and group C(P>0.05). Compared with Group A and Group B, EDV and ESV were larger of body and global in Group C(P<0.05); ESV were larger of inflow and outflow(P<0.05). EDV was larger of Group C than Group B(P<0.05). Compared with Group A and Group B, the EF of inflow, outflow and global in Group C were lower(P<0.05). The EF of body in Group C were lower than Group B(P < 0.05). There was no significant difference in regional and global volume and ejection fraction between group A and group B(P>0.05). Beside, there was no significant difference of SV among the three groups(P>0.05). A positive correlation was found between S ’, TAPSE, RVFAC and 3D-RVEF(r =0.39, 0.54, 0.91, respectively, all P<0.05). However, a negative correlation was showed between RVMPI and 3D-RVEF(r =-0.39, P>0.05). The intra-observer and inter-observer’s variability was low and consistency was high.Conclusions S ’, RVMPI, TAPSE, RVFAC and 3D-RVEF are relatively good indexes to reflect the right ventricular function. In patients with RV myocardial infarction, RV regional and global volume was enlarged and systolic function was impaired differently, the volume of inflow and body increased significantly, the systolic function of inflow was impaired most significantly. The change of regional right ventricular motion was not explicitly related to the location of right coronary artery lesion, while regional wall motion abnormality of left ventricular was explicitly related to the location of left coronary artery lesion. Evaluating right ventricular volume and systolic function in patients with right coronary artery disease by real-time three-dimensional echocardiography has high repeatability. |
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