Basnight M A, Gonzalez M S, Kershenovich S C, Appleton C P
Cardiology Section, Veterans Affairs Hospital, Tucson, AZ 85723.
J Am Soc Echocardiogr. 1991 Nov-Dec;4(6):547-58. doi: 10.1016/s0894-7317(14)80213-7.
Abnormal pulmonary venous flow velocity patterns are present in multiple cardiac disease states, but the determinants of pulmonary venous flow velocity have not been fully elucidated. To determine the relative importance of several proposed factors that could influence pulmonary venous flow, anatomic, hemodynamic, and Doppler mitral and pulmonary venous flow velocity data were compared in 50 consecutive patients undergoing cardiac catheterization for clinical reasons. Pulmonary venous diastolic flow velocity was most strongly related to left ventricular isovolumetric relaxation time (r = -0.59), left ventricular end-diastolic pressure (LVEDP, r = 0.50), left atrial minimum volume (r = 0.50), mitral deceleration time (r = -0.50), and early diastolic mitral flow velocity (r = 0.45). Pulmonary venous systolic flow velocity related best with left atrial minimum volume (r = -0.45) and left atrial ejection fraction (r = 0.44). Pulmonary venous systolic flow velocity integral also showed the strongest relation with left atrial minimum volume (r = -0.48). Relations between pulmonary venous flow velocity and velocity time integrals and other variables were sometimes significantly different, apparently caused in part to differences in heart rate. These results suggest that pulmonary venous diastolic flow velocity is influenced by the same factors that influence early left ventricular diastolic filling; pulmonary venous systolic flow velocity relates best to left atrial volume and atrial ejection fraction and does not relate to left ventricular ejection fraction. Future studies analyzing pulmonary venous flow velocity variables should include data on both peak velocities and velocity time integrals as well as left atrial size and function.
多种心脏疾病状态下均存在异常的肺静脉血流速度模式，但肺静脉血流速度的决定因素尚未完全阐明。为了确定几种可能影响肺静脉血流的因素的相对重要性，对50例因临床原因接受心脏导管检查的连续患者的解剖学、血流动力学以及二尖瓣和肺静脉血流速度的多普勒数据进行了比较。肺静脉舒张期血流速度与左心室等容舒张时间（r = -0.59）、左心室舒张末期压力（LVEDP，r = 0.50）、左心房最小容积（r = 0.50）、二尖瓣减速时间（r = -0.50）以及舒张早期二尖瓣血流速度（r = 0.45）的相关性最强。肺静脉收缩期血流速度与左心房最小容积（r = -0.45）和左心房射血分数（r = 0.44）的相关性最佳。肺静脉收缩期血流速度积分与左心房最小容积的相关性也最强（r = -0.48）。肺静脉血流速度和速度时间积分与其他变量之间的关系有时存在显著差异，这显然部分是由心率差异所致。这些结果表明，肺静脉舒张期血流速度受影响左心室舒张早期充盈的相同因素影响；肺静脉收缩期血流速度与左心房容积和心房射血分数的相关性最佳，与左心室射血分数无关。未来分析肺静脉血流速度变量的研究应包括峰值速度和速度时间积分以及左心房大小和功能的数据。
