Mori Yoshiki, Rusk Rosemary A, Jones Michael, Li Xiang-Ning, Irvine Timothy, Zetts Arthur D, Sahn David J
Oregon Health and Science University, Portland, Oregon 97201-3098, USA.
J Am Coll Cardiol. 2002 Sep 18;40(6):1179-85. doi: 10.1016/s0735-1097(02)02074-0.
The purpose of the present study was to validate a newly developed three-dimensional (3D) digital color Doppler method for quantifying pulmonary regurgitation (PR), using an animal model of chronic PR.
Spectral Doppler methods cannot reliably be used to assess pulmonary regurgitation.
In eight sheep with surgically created PR, 27 different hemodynamic states were studied. Pulmonary and aortic electromagnetic (EM) probes and meters were used to provide reference right ventricular (RV) forward and pulmonary regurgitant stroke volumes. A multiplane transesophageal probe was placed directly on the RV and aimed at the RV outflow tract. Electrocardiogram-gated and rotational 3D scans were performed for acquiring dynamic 3D digital velocity data. After 3D digital Doppler data were transferred to a computer workstation, the RV forward and pulmonary regurgitant flow volumes were obtained by a program that computes the velocity vectors over a spherical surface perpendicular to the direction of scanning.
Pulmonary regurgitant volumes and RV forward stroke volumes computed by the 3D method correlated well with those by the EM method (r = 0.95, mean difference = 0.51 +/- 1.89 ml/beat for the pulmonary regurgitant volume; and r = 0.91, mean difference = -0.22 +/- 3.44 ml/beat for the RV stroke volume). As a result of these measurements, the regurgitant fractions derived by the 3D method agreed well with the reference data (r = 0.94, mean difference = 2.06 +/- 6.11%).
The 3D digital color Doppler technique is a promising method for determining pulmonary regurgitant volumes and regurgitant fractions. It should have an important application in clinical settings.
本研究旨在使用慢性肺反流动物模型验证一种新开发的三维（3D）数字彩色多普勒方法，用于量化肺反流（PR）。
频谱多普勒方法不能可靠地用于评估肺反流。
对8只通过手术造成肺反流的绵羊，研究了27种不同的血流动力学状态。使用肺动脉和主动脉电磁（EM）探头及测量仪来提供右心室（RV）前向和肺反流搏出量的参考值。将多平面经食管探头直接置于右心室并对准右心室流出道。进行心电图门控和旋转3D扫描以获取动态3D数字速度数据。将3D数字多普勒数据传输到计算机工作站后，通过一个计算垂直于扫描方向的球面上速度矢量的程序获得右心室前向和肺反流流量。
3D方法计算的肺反流容积和右心室前向搏出量与EM方法计算的结果相关性良好（肺反流容积：r = 0.95，平均差值 = 0.51 ± 1.89 ml/搏；右心室搏出量：r = 0.91，平均差值 = -0.22 ± 3.44 ml/搏）。基于这些测量结果，3D方法得出的反流分数与参考数据吻合良好（r = 0.94，平均差值 = 2.06 ± 6.11%）。
3D数字彩色多普勒技术是一种有前景的确定肺反流容积和反流分数的方法。它在临床环境中应具有重要应用。
