Görgülü Sevket, Eren Mehmet, Yildirim Aydin, Ozer Orhan, Uslu Nevzat, Celik Seden, Dağdeviren Bahadir, Nurkalem Zekeriya, Bağirtan Bayram, Tezel Tuna
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Department, Istanbul, Turkey.
Anadolu Kardiyol Derg. 2003 Jun;3(2):92-7.
The state of pulmonary vascular bed in congenital heart disease is the predictor of the patients clinical condition, prognosis and outcome of surgical intervention. This study aims to investigate the condition of pulmonary vascular bed analyzing pulmonary artery stiffness by means of Doppler echocardiography.
Thirty-three patients (16 females, mean age 26+/-15 years) with various congenital heart diseases such as atrial septal defect (20 patients), ventricular septal defect (10 patients), patent ductus arteriosus (2 patients), atrioventricular septal defect (1 patient) were enrolled in this study. Systemic flow (Qs), pulmonary flow (Qp), systemic vascular resistance, pulmonary vascular resistance were calculated according to Fick method by using data obtained during left and right heart catheterization. Echocardiographically, pulmonary artery stiffness (PAS) was calculated by using maximal frequency shift (MFS) and acceleration time (AcT) of the pulmonary artery flow trace. PAS (kHz/sec)= MFS/AcT.
Invasively, the average Qp/Qs, mean pulmonary artery pressure, and pulmonary vascular resistance were found as 2.58+/-1.25, 25+/-20 mmHg, and 135+/-217 dyn.sec.cm-5, respectively. Echocardiographically, PAS was found to be 33+/-17 kHz/sec. Pulmonary artery stiffness was correlated with mean pulmonary artery pressure (r=0.63; p<0.001) and pulmonary vascular resistance (r=0.55, p<0.001), while no relation was found with Qp/Qs.
Estimation of pulmonary artery stiffness by using pulmonary flow maximal frequency shift and acceleration time obtained by means of Doppler echocardiography may give us an idea about the state of pulmonary vascular bed.
先天性心脏病患者肺血管床状态是其临床状况、预后及手术干预结果的预测指标。本研究旨在通过多普勒超声心动图分析肺动脉僵硬度来研究肺血管床状况。
本研究纳入了33例（16例女性，平均年龄26±15岁）患有各种先天性心脏病的患者，如房间隔缺损（20例）、室间隔缺损（10例）、动脉导管未闭（2例）、房室间隔缺损（1例）。根据菲克法，利用左右心导管检查期间获得的数据计算体循环血流量（Qs）、肺循环血流量（Qp）、体循环血管阻力和肺血管阻力。通过超声心动图，利用肺动脉血流轨迹的最大频移（MFS）和加速时间（AcT）计算肺动脉僵硬度（PAS）。PAS（kHz/秒）=MFS/AcT。
有创检查时，平均Qp/Qs、平均肺动脉压和肺血管阻力分别为2.58±1.25、25±20 mmHg和135±217 dyn.sec.cm-5。超声心动图检查发现，PAS为33±17 kHz/秒。肺动脉僵硬度与平均肺动脉压（r = 0.63；p<0.001）和肺血管阻力（r = 0.55，p<0.001）相关，而与Qp/Qs无关。
利用多普勒超声心动图获得的肺动脉血流最大频移和加速时间来估计肺动脉僵硬度，可能有助于我们了解肺血管床的状态。
