Friedberg Mark K, Feinstein Jeffrey A, Rosenthal David N
Division of Pediatric Cardiology, The Lucile Packard Children's Hospital, Stanford University, Stanford, California, USA.
J Am Soc Echocardiogr. 2006 May;19(5):559-62. doi: 10.1016/j.echo.2005.12.020.
Current noninvasive methods for estimating diastolic and mean pulmonary artery pressures (PAp) in children are cumbersome and have limited accuracy. We hypothesized that systolic PAp correlates with diastolic and mean PAp, and that this correlation can be used to estimate diastolic and mean PAp from Doppler flow data.
We recorded PAp in 112 patients 30 years or younger catheterized for heart failure, heart transplant, pulmonary hypertension, or congenital heart disease. We derived the relationship of systolic PAp to diastolic and mean PAp. We then applied these relations to systolic PAp measured by tricuspid regurgitation (TR) Doppler flow in a subset of 17 patients with pulmonary hypertension to predict mean and diastolic PAp, and correlated the results.
An excellent linear relation was found between systolic PAp and both the diastolic and mean PAp measured at cardiac catheterization (r = 0.95, P < .0001; r = 0.98, P < .0001, respectively). The calculated diastolic PAp calculated from TR Doppler correlated well with invasive data (31 +/- 13 vs 30 +/- 11 mm Hg, respectively, not significant; r = 0.85, P < .0001) and surpassed existing methods that are based on pulmonary regurgitation for predicting diastolic PAp. Similarly, mean PAp calculated from TR Doppler flow correlated well with invasive data (r = 0.86, P < .0001).
A strong linear relationship between systolic and diastolic PAp allows for easy and accurate noninvasive estimation of diastolic and mean PAp from TR Doppler flow.
目前用于估计儿童舒张期和平均肺动脉压（PAp）的非侵入性方法繁琐且准确性有限。我们假设收缩期PAp与舒张期和平均PAp相关，并且这种相关性可用于根据多普勒血流数据估计舒张期和平均PAp。
我们记录了112例30岁及以下因心力衰竭、心脏移植、肺动脉高压或先天性心脏病而接受心导管检查患者的PAp。我们得出了收缩期PAp与舒张期和平均PAp之间的关系。然后，我们将这些关系应用于17例肺动脉高压患者亚组中通过三尖瓣反流（TR）多普勒血流测量的收缩期PAp，以预测平均和舒张期PAp，并对结果进行相关性分析。
发现收缩期PAp与心导管检查时测量的舒张期和平均PAp之间存在极好线性关系（分别为r = 0.95，P <.0001；r = 0.98，P <.0001）。根据TR多普勒计算的舒张期PAp与侵入性数据相关性良好（分别为31±13与30±11 mmHg，无显著差异；r = 0.85，P <.0001），并超过了基于肺动脉反流预测舒张期PAp的现有方法。同样，根据TR多普勒血流计算的平均PAp与侵入性数据相关性良好（r = 0.86，P <.0001）。
收缩期和舒张期PAp之间的强线性关系允许从TR多普勒血流轻松准确地非侵入性估计舒张期和平均PAp。
