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| Assessment of right atrial function in patients with pulmonary hypertension in WHO functional class Ⅰ using real-time three-dimensional echocardiography |
| CHEN Ming CHENG Qi LI Yan XIANG Guangcai |
| Department of Ultrasound, the Affiliated Shenzhen Bao'an Hospital of Southern Medical University, Guangdong Province, Shenzhen 518101, China |
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Abstract Objective To assess right atrial function in patients with pulmonary hypertension (PH) in WHO functional classⅠ (WHO FCⅠ) using real-time three-dimensional echocardiography(RT-3DE). Methods From February 2014 to June 2016, in Affiliated Shenzhen Bao'an Hospital of Southern Medical University, 41 patients with PH in WHO FCⅠ were chosen as PH group, and 32 healthy volunteers were chosen as normal control group. RT-3DE full volume images of right atrium at apical four chamber view were collected. Right atrium volume during different cardiac cycle were acquired, and were corrected to body surface area, then right atrium maximal volume index (RAVImax)，right atrium minimal volume index (RAVImin) and right atrium pre-systolic volume index (RAVIpre) were derived from QLAB 9.0 (10.5) workstation. The following right atrium total emptying volume index (RAVIt = RAVImax-RAVImin), right atrium active emptying volume index (RAVIa = RAVIpre-RAVImin), right atrium passive emptying volume index (RAVIp = RAVImax-RAVIpre), right atrium passive emptying fraction (RAEFp = RAVIp/RAVIt×100%), right atrium active emptying fraction (RAEFa = RAVIa/RAVIt×100%) were calculated, respectively. And tricuspid annular plane systolic excursion (TAPSE) during systole were measured by M-mode echocardiography. Right ventricular ejected fraction (RVEF) was derived from 2DE Simpson. The tricuspid annulus velocity (e,a) of right ventricular free wall during diastole were recorded by tissue Doppler imaging, and e/a was calculated. Results There were no significance of RVEF, TAPSE between two groups, RAVImax,RAVImin, RAVIpre, RAVIt, RAVIa, RAEFa were greater than those of normal control group (P < 0.05 or P < 0.01), except that RAVIp, RAEFp, e/a were less than those of normal control group (P < 0.05). Conclusion Right atrial reservoir function and booster pump function increase, while right atrial conduit function decreases in WHO FCⅠPH. RT-3DE has potential ability to evaluate right atrial function.
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