Evaluation Of Right-Ventricular Function Evaluation In Chronic Thromboembolic Pulmonary Hypertension With Real-time Three-dimensional Echocardiography

Objective:To study the right-ventricular function parameters in chronic thromboembolic pulmonary hypertension(CTEPH)with Real-time three-dimensional echocardiography(RT-3DE).Methods:47 CTEPH patients were enrolled in this study in our hospital from November 2014 to October 2016 to be experimental group,male to female 1.9:1,mean age(66.92±7.02)these patients were divided into two groups,Group A with plasma NT-proBNP<900pg/mL,totally 26 cases and mean age(67.48±7.00)years and group B the plasma NT-proBNP?900pg/mL,26 cases with mean age(66.35±7.04)years.Inclusion criteria:(1)First diagnosed as CTEPH in our hospital;(2)The clinical signs and symptoms,laboratory examination and blood analysis are all accordance with the diagnosis of pulmonary embolism;(3)Conform to the 2015 ESC Guidelines for the diagnosis and treatment of pulmonary hypertension of echocardiography;(4)CT pulmonary angiography showed a pulmonary artery thrombosis.Exclusion followings:(1)Pulmonary arterial hypertension from congenital heart disease and idiopathic pulmonary hypertension;(2)Pulmonary hypertension due to left heart disease,such as left ventricular systolic dysfunction,valvular disease,cardiomyopathy;(3)Pulmonary hypertension due to disease and/or hypoxia,such as chronic obstructive pulmonary disease and interstitial pneumonia;(4)Pulmonary hypertension with unclear and/or multiple factors mechanisms such as connective tissue disease,blood system diseases,chronic renal failure.SIEMENS ACUSON SC2000 echocardiographic was used,with probe is 4V1c,frequency 2.0?4.0MHz,and probe 4Z1c,frequency of 1.0?4.0MHz.Equipment parameter were set as depth of 16 cm,volumetric frame rate>20 volume/s,colour Doppler three-dimensional fan angle of 40°×40°,a depth of 16 cm and plot frame rate>20 volume/s.Right ventricular volume automatic software,were used to analyse right ventricular parameters.Echocardiographic parameters:Three-dimensional parameters of right ventricular were enrolled as following:end diastolic volume(RVEDV),right ventricular end systolic volume(RVESV),right ventricular stroke(RVSV),right ventricular ejection fraction(RVEF).We standardized part of the parameters for body surface area(BSA),and get end diastolic volume index(RVEDVi),right ventricular end systolic volume index(RVESVi),right ventricular stroke index(RVSVi).We also measured tricuspid annular plane systolic excursion(TAPSE)using two-dimensional parameters.We analyse and compare group A and B statistically.Results:There were no obvious difference of TAPSE?RVES Vi and RVSVi between the two groups(all P>0.05).RVEDVi of group A was less than group B(P<0.05),RVEF of group A was higher than group B(P<0.05),and differences is significant between the two groups.Spearman correlation analysis shows that the NT-proBNP and RVESVi,RVEDVi as a positive correlation,negative correlation with RVEF,and RVSVi TAPSE no correlation.Conclusion:Compared with the two-dimensional parameter TAPSE,three-dimensional parameter RVEF,RVEDVi reflected more right ventricular function in patients with CTEPH.With elevated levels of plasma NT-proBNP,right ventricular function in patients with CTEPH reduce,right ventricular volume index increase.