Masuyama T, Uematsu M, Nakatani S, Sato H, Kodama K
Cardiovascular Division, Osaka Police Hospital, Japan.
J Am Soc Echocardiogr. 1991 Jan-Feb;4(1):35-42. doi: 10.1016/s0894-7317(14)80158-2.
Transpulmonic pressure gradient and pulmonary artery pressures can be estimated from the Doppler pulmonary regurgitant flow velocities by applying the simplified Bernoulli equation. In this study, continuous-wave Doppler echocardiography was used to assess changes in pulmonary regurgitant flow velocities associated with administration of vasodilators in 10 patients with congestive heart failure. M-Mode echocardiographic parameters such as left ventricular end-systolic and end-diastolic dimension and fractional shortening did not change with administration of vasodilators. Pulmonary regurgitant flow velocity at end diastole decreased from 1.9 +/- 0.6 to 1.3 +/- 0.3 m/sec (p less than 0.01), and Doppler-estimated transpulmonic pressure gradient at end diastole decreased from 16 +/- 11 to 8 +/- 4 mm Hg (p less than 0.01). Doppler-estimated transpulmonic pressure gradient at end diastole was compared with catheterization-determined pulmonary arterial end-diastolic pressure before and after administration of vasodilators in three patients, and there was a good agreement between these measurements. Thus noninvasive and sensitive assessment of the effect of vasodilators on pulmonary arterial end-diastolic pressure in patients with congestive heart failure is possible with continuous-wave Doppler echocardiographic measurement of pulmonary regurgitant flow velocities.
通过应用简化的伯努利方程，可根据多普勒肺动脉反流流速估算跨肺压差和肺动脉压力。在本研究中，使用连续波多普勒超声心动图评估了10例充血性心力衰竭患者使用血管扩张剂后肺动脉反流流速的变化。M型超声心动图参数，如左心室收缩末期和舒张末期内径以及缩短分数，在使用血管扩张剂后并未改变。舒张末期肺动脉反流流速从1.9±0.6降至1.3±0.3米/秒（p<0.01），舒张末期多普勒估算的跨肺压差从16±11降至8±4毫米汞柱（p<0.01）。在3例患者中，比较了舒张末期多普勒估算的跨肺压差与血管扩张剂给药前后心导管检查测定的肺动脉舒张末期压力，这些测量结果之间具有良好的一致性。因此，通过连续波多普勒超声心动图测量肺动脉反流流速，可以对充血性心力衰竭患者血管扩张剂对肺动脉舒张末期压力的影响进行无创且敏感的评估。
