功能性三尖瓣反流与右室–肺动脉耦联关系的研究进展  

Research Progress on the Relationship between Functional Tricuspid Regurgitation and Right Ventricular-Pulmonary Artery Coupling

作　　者：张曦 周平安[2] 

机构地区：[1]延安大学医学院,陕西 延安 [2]延安大学附属医院心脑血管病院超声诊断科,陕西 延安

出　　处：《临床医学进展》2023年第12期19934-19941,共8页Advances in Clinical Medicine

摘　　要：显著的功能性三尖瓣反流是心血管事件的独立预后因素,会导致右心重塑和功能障碍从而增加死亡率,并且死亡率及发病率与反流分级的增加也显著相关。近年来对于在出现严重右心室功能障碍之前进行早期干预这一观点重新引起临床医生的兴趣,对于三尖瓣反流如何干预以及何时干预仍是亟待解决的问题。功能性三尖瓣反流与右室功能、肺动脉负荷关系密切,右室功能适应持续增加的后负荷会维持右室–肺动脉耦联状态,而右心室重构不能适应变化的后负荷可导致其解耦联。因此,准确评估适应性向非适应性重构的转变时机对于对功能性三尖瓣反流患者的病情评估、临床决策、风险分层和预后判断具有重要意义。Significant functional tricuspid regurgitation is an independent prognostic factor for cardiovascular events, leading to right heart remodeling and dysfunction and thus increased mortality, also mor-tality and morbidity are significantly associated with increased regurgitant grading. In recent years there has been a resurgence of interest among clinicians in the idea of early intervention before se-vere right ventricular dysfunction develops. Thus, the question of how and when to intervene in tricuspid regurgitation remains urgent. Functional tricuspid regurgitation is closely related to right ventricular function and pulmonary artery loading;adaptation of right ventricular function to con-tinuously increasing afterload maintains right ventricular-pulmonary artery coupling, whereas failure of right ventricular remodeling to adapt to changing afterload can lead to its uncoupling. Therefore, accurate assessment of the timing of the transition from adaptive to nonadaptive re-modeling is important for condition assessment, clinical decision making, risk stratification, and prognosis in patients with functional tricuspid regurgitation.

关 键 词：三尖瓣 三尖瓣关闭不全 右室–肺动脉耦联 心室功能 右室重构 

分 类 号：R54[医药卫生—心血管疾病]