Gurudevan Swaminatha V, Malouf Philip J, Kahn Andrew M, Auger William R, Waltman Thomas J, Madani Michael, Demaria Anthony N, Blanchard Daniel G
Division of Cardiology, University of California Irvine School of Medicine, Irvine, USA.
J Am Soc Echocardiogr. 2007 Oct;20(10):1167-71. doi: 10.1016/j.echo.2007.02.004. Epub 2007 Jun 12.
Pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) are important hemodynamic parameters in patients with advanced cardiopulmonary disease. We undertook this study to determine whether Doppler tissue imaging of the tricuspid annulus could be used to assess PAP and PVR noninvasively.
We studied 50 consecutive patients with suspected chronic thromboembolic pulmonary hypertension referred to our center for evaluation. We performed preoperative transthoracic echocardiography with Doppler tissue imaging of the tricuspid annulus. All patients then underwent cardiac catheterization with invasive determination of cardiac output, PAP, and PVR.
The systolic velocity of the tricuspid annulus (tS(m)) had an inverse relationship with catheterization-derived mean PAP, with a correlation coefficient of -0.493 (P = .0003). The inverse correlation of tS(m) with catheterization-derived PVR was more striking, with a correlation coefficient of -0.710 (P < .0001). Based on the data, we derived the following logarithmic regression equation: PVR = 3698 - 1227 x ln(tS(m)).
Doppler tissue imaging of the lateral tricuspid annulus is a useful clinical tool that can provide a noninvasive estimate of PVR in patients with chronic thromboembolic pulmonary hypertension. In this population, decreasing values of tS(m) predicted progressively higher measurements of PVR.
肺动脉压（PAP）和肺血管阻力（PVR）是晚期心肺疾病患者重要的血流动力学参数。我们开展这项研究以确定三尖瓣环的多普勒组织成像是否可用于无创评估PAP和PVR。
我们研究了连续50例因疑似慢性血栓栓塞性肺动脉高压转诊至本中心进行评估的患者。我们在术前进行经胸超声心动图检查并对三尖瓣环进行多普勒组织成像。然后所有患者接受心导管检查以有创测定心输出量、PAP和PVR。
三尖瓣环的收缩期速度（tS(m)）与心导管检查得出的平均PAP呈负相关，相关系数为 -0.493（P = .0003）。tS(m)与心导管检查得出的PVR的负相关性更为显著，相关系数为 -0.710（P < .0001）。基于这些数据，我们得出以下对数回归方程：PVR = 3698 - 1227 x ln(tS(m))。
三尖瓣环外侧的多普勒组织成像是一种有用的临床工具，可对慢性血栓栓塞性肺动脉高压患者的PVR进行无创估计。在这一人群中，tS(m)值降低预示着PVR测量值逐渐升高。
