使用经胸多普勒超声心动图诊断右心室压力升高儿童的后降支冠状动脉血流速度储备降低。

Using transthoracic Doppler echocardiography to diagnose reduced coronary flow velocity reserve in the posterior descending coronary artery in children with elevated right ventricular pressure.

作者信息

Shimada Shunsuke, Harada Kenji, Toyono Manatomo, Tamura Masamichi, Takada Goro

机构信息

Department of Pediatrics, Akita University School of Medicine, Japan.

出版信息

Circ J. 2007 Dec;71(12):1912-7. doi: 10.1253/circj.71.1912.

DOI:10.1253/circj.71.1912

PMID:18037745

Abstract

BACKGROUND

Advances in transthoracic Doppler echocardiography enable noninvasive measurements of coronary flow velocity and coronary flow velocity reserve (CFVR) in the posterior descending coronary artery (PD).

METHODS AND RESULTS

To evaluate CFVR in the PD of children with elevated right ventricular (RV) pressure, 19 children with RV pressure overload and 13 age-matched controls with normal RV pressure were studied using transthoracic Doppler echocardiography. Average peak flow velocity (APV) was measured at rest and in hyperemic conditions (intravenous administration of adenosine of 0.16 mg.kg(-1).min(-1)). Compared with controls, the PD CFVR was significantly reduced in the patients with elevated RV pressure (1.87+/-0.42 vs 2.49+/-0.55, p<0.01) because their mean baseline APV was significantly greater (27+/-6 vs 19+/-4 cm/s, p<0.01), although hyperemic APV was not significantly different (49+/-10 vs 48+/-14 cm/s, p=NS).

CONCLUSIONS

PD CFVR is limited in patients with elevated RV pressure because of elevation of the baseline resting flow velocity.

摘要

背景

经胸多普勒超声心动图技术的进展使得能够对后降支冠状动脉（PD）的冠状动脉血流速度和冠状动脉血流储备（CFVR）进行无创测量。

方法与结果

为评估右心室（RV）压力升高的儿童的PD中的CFVR，使用经胸多普勒超声心动图对19例RV压力过载儿童和13例年龄匹配的RV压力正常的对照儿童进行了研究。在静息状态和充血状态下（静脉注射0.16 mg·kg⁻¹·min⁻¹的腺苷）测量平均峰值流速（APV）。与对照组相比，RV压力升高的患者的PD CFVR显著降低（1.87±0.42对2.49±0.55，p<0.01），因为他们的平均基线APV显著更高（27±6对19±4 cm/s，p<0.01），尽管充血时的APV没有显著差异（49±10对48±14 cm/s，p=无显著性差异）。