2026 年第 4 期 第 21 卷

术前超声预测与术后实时超声在左心室辅助装置植入患者右心功能管理中的作用概述

Overview of the role of preoperative ultrasound prediction and postoperative real-time ultrasound in the management of right cardiac function in patients with left ventricular assist device implantation

作者：朱惟一赵双雷温明修鲁亦凡陈峥岌李前贤胡熠陈思吉贡鸣

英文作者：Zhu Weiyi Zhao Shuanglei Wen Mingxiu Lu Yifan Chen Zhengji Li Qianxian Hu Yi Chen Siji Gong Ming

单位：首都医科大学附属北京安贞医院心力衰竭与瓣膜外科中心，北京100029

英文单位：Heart Failure and Valvular Surgery Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：右心衰竭；左心室辅助装置；超声心动图；应变成像；右心室-肺动脉偶联

英文关键词：Rightheartfailure;Leftventricularassistdevice;Echocardiography;Strainimaging;Rightventricle-pulmonaryarterycoupling

• 摘要：

• 左心室辅助装置（LVAD）植入后右心衰竭是决定预后的关键并发症之一。随着第三代磁悬浮连续流装置在我国逐步普及，术前以超声为核心的右心风险预测以及术后以床旁超声为中心的实时检测，成为降低右心衰竭发生率与病死率的可行路径。本文在梳理我国LVAD应用格局与人群特征的基础上，系统总结右心衰竭的最新定义与分型，归纳术前超声具有可重复性和准确性的预测指标，提出术后随访的超声序列与随访时间点，并构建超声驱动的干预决策流程，旨在为多学科治疗团队提供一套诊疗框架和随访参考。

• Right heart failure following left ventricular assist device (LVAD) implantation is one of the key complications determining prognosis. With the gradual popularization of the third-generation magnetic levitation continuous-flow devices in China, preoperative ultrasound-based risk prediction of right heart failure and postoperative bedside ultrasound-centered real-time monitoring have become feasible approaches to reduce the incidence and mortality of right heart failure. Based on sorting out the application pattern and population characteristics of LVAD in China, this paper systematically summarizes the latest definition and classification of right heart failure, concludes the preoperative ultrasound predictors with good repeatability and accuracy, proposes the ultrasound sequence and follow-up time points for postoperative follow-up, and constructs an ultrasound-driven intervention decision-making process. The aim is to provide a set of diagnosis and treatment framework and follow-up reference for the multidisciplinary treatment team.