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Assessment of Right Ventricular Function in Recipient Twin of Twin to Twin Transfusion Syndrome with Speckle Tracking Echocardiography

机译:散斑跟踪超声心动图评估双胞胎至双胞胎输血综合征的双胞胎右心室功能

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This study was undertaken to evaluate the right ventricular myocardial systolic function and its relation to the fetal volume and pressure overload in recipient twin of twin to twin transfusion syndrome with speckle tracking echocardiography. Longitudinal peak systolic strains of the right ventricle were measured by speckle tracking echocardiography in 17 patients with twin-to-twin transfusion syndrome (TTTS) and 19 normal monochorionic diamniotic pregnancies. The right ventricular free wall thickness in recipient twin (0.43 ± 0.14 cm) was significantly larger than that in the donor (0.21 ± 0.04 cm, p < 0.05) and the control group (0.18 ± 0.03 cm, p < 0.05 for larger twin and 0.17 ± 0.02 cm, p < 0.05 for smaller twin). Although there were no significant differences in the right ventricular fractional shortening and cavity area percent change among control and the TTTS groups, the absolute value of peak systolic strains of ventricular septum, right ventricular free wall and global right ventricle in recipients were all significantly lower than those of the donors and the control group. Besides, the global right ventricular peak systolic strain correlated well with gestational age adjusted right ventricular free wall thickness (r = 0.65, p = 0.04) but not with gestational age adjusted right ventricular end-diastolic dimension (r = 0.38, p = 0.28) and cavity area percent change (r = 0.33, p = 0.35). Right ventricular systolic dysfunction measured with decreased right ventricular peak systolic longitudinal strain exists despite the absence of diminished fractional shortening and cavity area percent change and this reduced systolic function correlates with the right ventricular pressure overload as shown by increased right ventricular free wall thickness.
机译:这项研究旨在通过散斑跟踪超声心动图评估双胞胎到双胞胎输血综合征患者双胞胎的右心室心肌收缩功能及其与胎儿容量和压力超负荷的关系。通过斑点跟踪超声心动图测量了17例双胎双输血综合征(TTTS)和19例正常单绒毛膜羊膜炎孕妇的右心室纵向收缩峰值。受者双胞胎的右心室自由壁厚度(0.43±0.14 cm)显着大于供体(0.21±0.04 cm,p <0.05)和对照组(0.18±0.03 cm,p <0.05) 0.17±0.02厘米,对于较小的双胞胎,p <0.05)。尽管对照组和TTTS组之间右室分数缩短和腔面积百分比变化无显着差异,但接受者的室间隔,右室游离壁和整体右室峰值收缩应变的绝对值均显着低于接受者。捐助者和对照组的那些。此外,总体右室收缩高峰应变与经胎龄调整的右心室游离壁厚度(r = 0.65,p = 0.04)相关性很好,但与经胎龄调整的右心室舒张末期尺寸(r = 0.38,p = 0.28)相关性很好和空腔面积百分比变化(r = 0.33,p = 0.35)。尽管缺乏缩短的缩短和腔面积百分比变化,但仍存在以减少的右心室收缩峰值收缩纵向应变而测量的右心室收缩功能障碍,这种收缩功能的降低与右心室压力超负荷相关,如右心室自由壁厚度的增加所示。

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