Ultrasound evaluation of speckle tracking imaging on right ventricular function and right ventricular pulmonary artery coupling in severe pneumonia underwent mechanical ventilation versus common pneumonia

doi:10.3969/j.issn.1004-583X.2024.06.008

Abstract

Abstract:

Objective To analyze ultrasound evaluation of two-dimensional speckle tracking imaging (2D-STI) on right ventricular (RV) function and RV- pulmonary artery coupling in severe pneumonia underwent mechanical ventilation versus common pneumonia. Methods Sixty-six patients of pneumonia were divided into severe pneumonia group (group S, 25 cases) and general pneumonia group (group G, 41 cases), and 20 healthy people were enrolled as control group. Ultrasonic parameters were obtained in apical four-chamber images, including RV diameter (RVD), tricuspid annular plane systolic excursion (TAPSE), tricuspid lateral annular peak systolic velocity (S'), tricuspid regurgitation velocity (TRV). Inferior vena cava diameter (IVCD) and inferior vena cava variability (IVCV), and the RV pressure (RVP) were estimated, and pulmonary artery systolic pressure (PASP) was calculated. The RV-pulmonary artery coupling index was represented by TAPSE/PASP. The 2D-STE was performed to observe strain parameters, including right ventricular longitudinal strain in the free wall (RVLSfw), right ventricular longitudinal strain in the basal segment (RVLSbas), right ventricular longitudinal strain in the middle segment (RVLSmid), and right ventricular longitudinal strain in the apical segment (RVLSapi). The new index RVLSfw/PASP was obtained by incorporating RVLSfw into the RV-pulmonary artery coupling. The between groups differences and the correlation were assessed. Results RVD, IVCD, TRV and PASP in group S were significantly higher than those in group G and control group, while IVCV and TAPSE were significantly lower (P<0.05). S’ in group S was significantly lower than that in group G (P<0.05). RVD and IVCD in group G were significantly higher than those in control group (P<0.05). 2D-STI indexes including RVLSfw, RVLSbas and RVLSapi in group S were significantly lower than those in group G and control group (P<0.05). There was no statistically significant difference in 2D-STI indexes between group G and control group (P>0.05). RV-pulmonary artery coupling indexes including TAPSE/PASP, S'/PASP and RVLSfw/PASP in group S were significantly lower than those in group G and control group, and there was no statistical significance in RV-pulmonary artery coupling indexes between group G and control group (P>0.05). RVLSfw/PASP was strongly correlated with TAPSE/PASP (r=0.927, P<0.05). Conclusion Both 2D-STI index and RV-pulmonary artery coupling have certain value in evaluating the RV function of patients with severe pneumonia underwent mechanical ventilation. RVLSfw/PASP can be used as a reliable index to evaluate RV-pulmonary artery coupling.

Key words: severe pneumonia, ventricular function,right, two-dimensional speckle tracking imaging, right ventricle-pulmonary artery coupling, tricuspid annular plane systolic excursion

CLC Number:

R563.1

Yan Yaru, Zhao Haotian, Zhang Jiesi, Wang Xiaona, Zhao Heling. Ultrasound evaluation of speckle tracking imaging on right ventricular function and right ventricular pulmonary artery coupling in severe pneumonia underwent mechanical ventilation versus common pneumonia[J]. Clinical Focus, 2024, 39(6): 531-536.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.06.008

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I6/531

Figures/Tables 4

References 15

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组别	例数	RVD(mm)	IVCD(mm)	IVCV(%)	TRV(m/s)	PASP(mmHg)	TAPSE(mm)	S’(cm/s)
重症肺炎组	25	31.24±4.63	16.02±4.50	33.63±13.92	2.65±0.39	37.04±9.33	17.93±3.53	11.60±3.04
普通肺炎组	41	29.10±3.25^*	13.35±4.06^*	46.18±12.15^*	2.27±0.37^*	27.85±9.21^*	19.39±2.25^*	13.20±2.69^*
对照组	20	27.10±2.34^*#	10.57±2.89^*#	50.76±8.93^*	2.25±0.26^*	26.55±5.85^*	20.44±2.17^*	12.35±1.50
F值		7.678	10.555	13.009	10.150	11.237	5.094	3.021
P值		0.001	0.002	<0.001	<0.001	<0.001	0.008	0.054

组别	例数	RVD(mm)	IVCD(mm)	IVCV(%)	TRV(m/s)	PASP(mmHg)	TAPSE(mm)	S’(cm/s)
重症肺炎组	25	31.24±4.63	16.02±4.50	33.63±13.92	2.65±0.39	37.04±9.33	17.93±3.53	11.60±3.04
普通肺炎组	41	29.10±3.25^*	13.35±4.06^*	46.18±12.15^*	2.27±0.37^*	27.85±9.21^*	19.39±2.25^*	13.20±2.69^*
对照组	20	27.10±2.34^*#	10.57±2.89^*#	50.76±8.93^*	2.25±0.26^*	26.55±5.85^*	20.44±2.17^*	12.35±1.50
F值		7.678	10.555	13.009	10.150	11.237	5.094	3.021
P值		0.001	0.002	<0.001	<0.001	<0.001	0.008	0.054

组别	例数	RVLSfw(%)	RVLSbas(%)	RVLSmid(%)	RVLSapi(%)	TAPSE/PASP	S’/PASP	RVLSfw/PASP
重症肺炎组	25	-22.28±4.05	-27.68±4.86	-23.30±4.67	-15.84±4.31	0.52±0.17	0.34±0.14	-0.65±0.23
普通肺炎组	41	-25.07±3.37^*	-31.49±4.39^*	-25.40±4.04	-18.34±3.16^*	0.78±0.28^*	0.53±0.22^*	-1.00±0.36^*
对照组	20	-25.83±3.22^*	-30.72±3.71^*	-27.21±4.17^*	-19.61±2.80^*	0.82±0.25^*	0.49±0.15^*	-1.04±0.32^*
F值		6.824	6.016	4.745	7.187	10.668	8.294	11.381
P值		0.002	0.004	0.011	0.001	<0.001	0.001	<0.001

组别	例数	RVLSfw(%)	RVLSbas(%)	RVLSmid(%)	RVLSapi(%)	TAPSE/PASP	S’/PASP	RVLSfw/PASP
重症肺炎组	25	-22.28±4.05	-27.68±4.86	-23.30±4.67	-15.84±4.31	0.52±0.17	0.34±0.14	-0.65±0.23
普通肺炎组	41	-25.07±3.37^*	-31.49±4.39^*	-25.40±4.04	-18.34±3.16^*	0.78±0.28^*	0.53±0.22^*	-1.00±0.36^*
对照组	20	-25.83±3.22^*	-30.72±3.71^*	-27.21±4.17^*	-19.61±2.80^*	0.82±0.25^*	0.49±0.15^*	-1.04±0.32^*
F值		6.824	6.016	4.745	7.187	10.668	8.294	11.381
P值		0.002	0.004	0.011	0.001	<0.001	0.001	<0.001