The effect of preoperative pulmonary artery pressure on early postoperative right ventricular function in patients with heart transplantation
Huang Wen1, Wang Haiyan1, Xu Rui2
1Department of Medical Ultrasound, 2Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital), Jinan 250001, China
Abstract：ObjectiveTo investigate the effect of the preoperative pulmonary artery pressure on early postoperative right ventricular function in patients undergoing heart transplantation with left heart failure and receiving the heart transplantation. MethodsA retrospective analysis was made, which was based on 79 patients who underwent the orthotopic cardiac transplantation for endstage heart failure at the Heart Transplantation Center, the First Affiliated Hospital of Shandong First Medical University from August 2010 to February 2018. The systolic pulmonary artery pressure (PASP) was defined as the sum tricuspid regurgitation pressure difference and right atrial pressure measured by echocardiography. The patients were divided into the pulmonary hypertension group (preoperative PASP≥45mmHg, 1mmHg=0.133kPa),n=45) and the control group (preoperative PASP＜45mmHg, n=34) respectively.The preoperative general data, the intraoperative cardiopulmonary bypass time, and the early postoperative right heart function were analyzed and compared between the two groups. ResultsThe preoperative right ventricular outflow tract forward blood flow acceleration time (RVact) was (96.83±8.53) ms in the pulmonary hypertension group, (106.00±4.90)ms in the control group. The difference was statistically significant (t=-6.05, P＜0.01). The intraoperative cardiopulmonary bypass time of pulmonary hypertension group ［（266.69±71.80）min］ was higher than that of the control group ［（221.24±70.19）min］, the difference was statistically significant （t=2.81, P＜0.01）. The right ventricular longitudinal strain (RVLS) ［（-12.19±2.03）%,（-19.22±2.06）%］ and the right ventricular fractional area change (RVFAC) ［（26.88±6.15）%,（36.50±2.17）%］ were analyzed by echocardiography 3 days after operation between the two groups, and the differences were statistically significant (t=15.11, -9.72, all P＜0.01). In addition，the differences of RVLS ［（-12.02±1.99）%，（-19.40±1.82）%］, tricuspid annular plane systolic excursion (TAPSE) ［（17.46±2.06）mm，（18.68±1.74）mm］ and RVFAC ［（29.50±6.28）%，（37.60±2.72）%］ between the two groups in echocardiography 15 days after operation were also statistically significant （t=17.14, -2.85, -7.74, all P＜0.01). ConclusionPatients with preoperative PASP≥45mmHg are more likely to develop the severe right ventricular insufficiency in the early postoperative period after heart transplantation.
黄文 王海燕 徐瑞. 超声心动图评估心脏移植患者术前肺动脉
压力对术后早期右心功能的影响[J]. 中华诊断学电子杂志, 2021, 9(4): 221-225.
Huang Wen1, Wang Haiyan1, Xu Rui2. The effect of preoperative pulmonary artery pressure on early postoperative right ventricular function in patients with heart transplantation. zhzdx, 2021, 9(4): 221-225.
