超声心动图观察二尖瓣及肺静脉血流参数与左心室舒张末压的关系  

Mitral inflow patterns and pulmonary venous flow velocities recorded by transthoracic Doppler echocardiography: relation to left ventricular end diastolic pressures

作　　者：周建庆 吉川纯一 

机构地区：[1]宁波医疗中心李惠利医院 [2]日本神户市立中央市民病院

出　　处：《中华心血管病杂志》1997年第1期43-46,共4页Chinese Journal of Cardiology

摘　　要：测定６０例心导管受检者左心室舒张期压力，经胸脉冲波多普勒超声心动图记录二尖瓣及肺静脉血流参数并与左心室充盈压作相关分析。发现肺静脉血流参数与左心室舒张压比二尖瓣血流更具相关性。肺静脉返流峰和二尖瓣Ａ峰时限差（ＰＡｄ－Ａｄ）与左室舒张末期压（ＥＤＰ）最具相关性（ｒ＝０．７０，Ｐ＜０．０１），肺静脉返流峰时限长于二尖瓣Ａ峰估测ＥＤＰ≥２ｋＰａ（１５ｍｍＨｇ）的敏感性为８６％、特异性为８１％。左室心房收缩前压力与肺静脉收缩分数呈明显负相关（ｒ＝－０．５９，Ｐ＜０．０１）。表明超声心动图能有效地估测左心室舒张期压力，ＰＡｄ－Ａｄ是估测左心室舒张末期压的最佳指标。肺静脉收缩分数减小提示左室心房收缩前压力明显升高。Objective: To determine whether Doppler derived pulmonary venous and mitral flow variables can provide a simple bedside method of estimating left ventricular end diastolic pressures(LVEDP). Patients and Methods: LVEDP were measured in 60 consecutive patients undergoing cardiac catheterization. Mitral and pulmonary venous flow velocity variables were recorded by transthoracic Doppler ultrasound and correlated with LVEDP. Results: velocity indices derived from pulmonary venous flow correlated better with LVEDP than did mitral flow variables. The difference in duration between the pulmonary venous regurgitant flow and mitral A wave had the best correlation with LVEDP ( r =0.70, P <0.01). A longer duration of the pulmonary venous A wave than that of mitral A wave predicted an end distolic pressure≥2 kPa (15mmHg), with a sensitivity of 86% and a specificity of 81%. Left ventricular pre A pressure was most strongly related to systolic fraction of pulmonary venous flow ( r =-0.59, P <0.01). Conclusion: The difference between the duration of pulmonary venous regurgitant flow and mitral A wave during atrial systole is a useful index of LVEDP. Decreased systolic fraction of pulmonary venous flow suggests markedly increased pre A pressure.

关 键 词：超声心动图 心脏导管插入 心功能 

分 类 号：R540.45[医药卫生—心血管疾病]