经多普勒超声心动图评估肺动脉反流有助于缩窄性心包炎的诊断。

Doppler echocardiographic evaluation of pulmonary regurgitation facilitates the diagnosis of constrictive pericarditis.

作者信息

Gilman Gregory, Ommen Steve R, Hansen William H, Higano Stuart T

机构信息

Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

J Am Soc Echocardiogr. 2005 Sep;18(9):892-5. doi: 10.1016/j.echo.2005.03.028.

DOI:10.1016/j.echo.2005.03.028

PMID:16153509

Abstract

Diagnosing constrictive pericarditis (CP) remains a clinical challenge. Ventricular interdependence and dissociation of intrathoracic and intracardiac pressures are hallmark features that are readily recognized by invasive and noninvasive hemodynamics. The Doppler echocardiographic signal from pulmonic valve regurgitation depends on the relationship between pulmonary artery (intrathoracic) and right ventricular (intracardiac) pressure. Respiration-associated changes in this signal may aid in the evaluation of pericardial constriction. We demonstrate here that early diastolic cessation with inspiration can indicate a CP process. Early diastolic cessation with inspiration was shown to have correctly diagnosed CP in 70% of the patients in this study, with a sensitivity of 77%, specificity of 64%, positive predictive value of 67%, and negative predictive value of 75%. This noninvasive insight into dissociation of intracardiac and intrathoracic pressures, although not sufficient on its own, may be a valuable tool for aiding in the diagnosis of CP.

摘要

诊断缩窄性心包炎（CP）仍然是一项临床挑战。心室相互依存以及胸内和心内压力的分离是侵入性和非侵入性血流动力学易于识别的标志性特征。来自肺动脉瓣反流的多普勒超声心动图信号取决于肺动脉（胸内）和右心室（心内）压力之间的关系。该信号中与呼吸相关的变化可能有助于评估心包缩窄。我们在此证明，吸气时舒张早期停止可提示CP过程。在本研究中，吸气时舒张早期停止被证明在70%的患者中正确诊断了CP，敏感性为77%，特异性为64%，阳性预测值为67%，阴性预测值为75%。这种对心内和胸内压力分离的非侵入性洞察，虽然仅凭其自身并不充分，但可能是辅助诊断CP的有价值工具。