Application value of real time three-dimensional echocardiography and velocity vector imaging technology for evaluat-ing right ventricular function in elderly patients with connective tissue disease complicated with pulmonary hypertension
LI Nannan
XU Yan
PAN Zhengmao
LI Minghao
Abstract：Objective To analyze the value of real-time three-dimensional echocardiography(RT-3DE)with velocity vector imaging(VVI)in the evaluation of right ventricular function in elderly patients with connective tissue disease(CTD)compli-cated with pulmonary hypertension.Methods 121 cases of elderly CTD(observation group)were selected,50 cases of pulmo-nary hypertension and 71 cases of normal pulmonary artery pressure were diagnosed by right heart catheterisation,and 121 volun-teers with healthy physical examination were screened by 1∶1 using propensity score matching method(control group).Right ventricular function was measured using RT-3DE and VVI,including early peak diastolic flow velocity,late peak diastolic flow velocity,peak systolic velocity,peak atrial systolic velocity,early peak diastolic velocity(e'),Tei index,tricuspid annular sys-tolic displacement(TAPSE),right ventricular ejection fraction(RVEF),right ventricular end-systolic volume index(RVESVI),right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricu-lar volume per beat(RVSV),volume-per-beat index,rate of change of right ventricular area(FAC),right ventricular end-diastolic volume index,mean strain(GS),right ventricular longitudinal strain standard deviation of time to peak(TLS-SD),and right ventricular free wall Longitudinal strain(FWS).The pulmonary artery systolic pressure(PASP),pulmonary artery dia-stolic pressure(PADP),pulmonary artery mean pressure(PAMP),right atrial pressure(RAP),and pulmonary capillary wedge pressure(PCWP)were measured via right heart catheterisation.The serum amino-terminal brain natriuretic peptide pre-cursor(NT-proBNP)was detected by ELISA.Then,we analysed the relationship between parameters related to right ventricular function and biomarkers(NT-proBNP)and haemodynamics,i.e.,PASP,PADP,PAMP,RAP,PCWP,in elderly CTD pa-tients.Results PASP and serum NT-proBNP levels were higher in the observation group than in the control group(all P<0.05).PASP and serum NT-proBNP levels were higher in the observation group than in those with normal pulmonary arterial pressure(all P<0.05).The right ventricular anteroposterior diameter and Tei index of the observation group were higher than those of the control group,and e'was lower than those of the control group(all P<0.05).The right ventricular anteroposterior di-ameter and Tei index of the observation group's patients with pulmonary hypertension were higher than those of their patients with normal pulmonary arterial pressure,and e'was lower than those of their patients with normal pulmonary arterial pressure(all P<0.05).TAPSE,RVEF,and FAC were lower in the observation group than those in the control group(all P<0.05),and TAPSE,RVEF,and FAC were lower in the observation group than those whose pulmonary artery pressure was normal(all P<0.05).TLS-SD of the observation group was higher than that of the control group,and FWS and GS were lower than those of the control group(all P<0.05).TLS-SD of pulmonary hypertension patients in the observation group was higher than that of those with normal pulmonary artery pressures,and FWS and GS were lower than those of those with normal pulmonary artery pressures(all P<0.05).PADP,PAMP,RAP,and PCWP were higher in the observation group than those in the control group(all P<0.05),and PADP,PAMP,RAP,and PCWP were higher in the observation group than those whose pulmonary artery pres-sure was normal(all P<0.05).Pearson correlation analysis showed that TAPSE,RVEF,FAC,GS,and FWS were negatively correlated with PASP,serum NT-proBNP levels and PADP,PAMP,RAP,and PCWP in elderly CTD patients(all P<0.05),while,TLS-SD was negatively correlated with PASP,serum NT-proBNP levels,and PADP,PAMP,RAP,and PCWP were posi-tively correlated(all P<0.05).Conclusion RT-3DE and VVI can accurately assess right ventricular impairment in elderly pa-tients with CTD combined with pulmonary hypertension who have reduced right ventricular systolic function.
Keywords：Real-time three-dimensional echocardiographyVelocity vector imaging techniqueConnective tissue diseasePulmonary hypertensionRight ventricular function
Publication Date：2025-12-30
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 31-36 )