Zhang Y
Affiliated Hospital, Shandong Medical University, Jinan.
Zhonghua Xin Xue Guan Bing Za Zhi. 1992 Dec;20(6):338-40, 388.
To assess the reliability of Doppler echocardiography (DE) in measuring the right ventricular systolic pressure (RVSP) in ventricular septal defect (VSD), both left and right heart catheterization (Cath) and DE were performed simultaneously in 59 cases with VSD. Systolic shunt velocities through VSD were recorded by DE and converted into the peak instantaneous (delta P-PD) and mid-systolic (delta P-MD) pressure gradients using the simplified Bernoulli equation RVSP was estimated by subtracting delta P-PD from the brachial artery systolic pressure (BASP) measured by a cuff sphygmomanometer (method A) and by subtracting delta P-MD from BASP (method B). The left ventricular systolic pressure (LVSP), RVSP, and the peak instantaneous (delta P-PC) and the peak-to-peak (delta P-PP) pressure gradients were measured from pressure c rves. The comparison between BASP and LVSP yielded a good correlation (r = 0.90, SEE = 0.76 kPa). There were also good correlation of interventricular pressure gradients measured by two techniques (r = 0.98, SEE = 0.83-0.93 kPa). Although RVSP estimated by method A correlated well with that measured by Cath, there was a significant underestimation (P < 0.05). On the other hand, RVSP estimated by method B agreed highly with that measured by Cath and there was no significant difference between the two means. We conclude that DE offers a reliable technique for estimating RVSP in VSD noninvasively.
为评估多普勒超声心动图(DE)测量室间隔缺损(VSD)患者右心室收缩压(RVSP)的可靠性,对59例VSD患者同时进行了左、右心导管检查(Cath)和DE检查。通过DE记录VSD处的收缩期分流速度,并使用简化伯努利方程将其转换为峰值瞬时(ΔP - PD)和收缩中期(ΔP - MD)压力阶差。通过袖带血压计测量肱动脉收缩压(BASP),用BASP减去ΔP - PD(方法A)以及用BASP减去ΔP - MD(方法B)来估算RVSP。从压力曲线测量左心室收缩压(LVSP)、RVSP以及峰值瞬时(ΔP - PC)和峰 - 峰(ΔP - PP)压力阶差。BASP与LVSP之间的比较显示出良好的相关性(r = 0.90,标准误 = 0.76 kPa)。两种技术测量的心室间压力阶差也具有良好的相关性(r = 0.98,标准误 = 0.83 - 0.93 kPa)。虽然方法A估算的RVSP与Cath测量的结果相关性良好,但存在显著低估(P < 0.05)。另一方面,方法B估算的RVSP与Cath测量的结果高度一致,且两种方法的均值之间无显著差异。我们得出结论,DE为无创估算VSD患者的RVSP提供了一种可靠的技术。