Tokgözoğlu S L, Kes S, Oram A, Demircin M, Paşaoğlu I, Uğurlu S
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Echocardiography. 1995 Jan;12(1):29-34. doi: 10.1111/j.1540-8175.1995.tb00518.x.
Fifteen patients with constrictive pericarditis were prospectively evaluated with echocardiography and Doppler recordings during respiratory monitoring. Eleven who agreed to surgery also underwent right heart catheterization and a repeat echocardiography with Doppler 10 days after pericardiectomy. Preoperatively, there was a significant inspiratory decrease in the mitral E wave (P < 0.05) and increase in the tricuspid E wave velocities (P < 0.05), which both normalized after pericardiectomy. The mitral deceleration times increased from 110 +/- 40 to 149 +/- 46 msec (P < 0.05) postoperatively. The preoperative hepatic vein velocities showed an accentuated systolic flow pattern. The systolic to diastolic ratio of the hepatic vein velocities was higher in patients who improved with surgery (1.42 +/- 0.31 vs 0.65 +/- 0.13) (P < 0.05). Postoperatively the diastolic flow became more pronounced. There was a 100% expiratory diastolic flow reversal in eight patients preoperatively, which normalized after pericardiectomy. Clinically these patients improved significantly postoperatively. Left atrial size, ejection fraction, and mitral and tricuspid filling velocities during respiratory monitoring could not predict surgical outcome. Pericardiectomy improved Doppler filling dynamics in all patients although this was not parallel to clinical improvement.
对15例缩窄性心包炎患者在呼吸监测期间进行了超声心动图和多普勒记录的前瞻性评估。11例同意手术的患者还接受了右心导管检查，并在心包切除术后10天进行了重复超声心动图和多普勒检查。术前，二尖瓣E波在吸气时显著降低（P<0.05），三尖瓣E波速度增加（P<0.05），心包切除术后两者均恢复正常。二尖瓣减速时间术后从110±40毫秒增加到149±46毫秒（P<0.05）。术前肝静脉速度显示收缩期血流模式增强。手术改善的患者肝静脉速度的收缩期与舒张期比值更高（1.42±0.31对0.65±0.13）（P<0.05）。术后舒张期血流变得更加明显。术前8例患者出现100%呼气末舒张期血流逆转，心包切除术后恢复正常。临床上，这些患者术后有显著改善。呼吸监测期间的左心房大小、射血分数以及二尖瓣和三尖瓣充盈速度无法预测手术结果。心包切除术改善了所有患者的多普勒充盈动力学，尽管这与临床改善并不平行。
