Ginghină Carmen, Muraru Denisa, Vlădaia Aurora, Jurcuţ Ruxandra, Popescu B A, Călin Andreea, Giuşcă S
Prof. Dr. C.C. Iliescu Institute of Cardiovascular Diseases, Bucharest, Romania.
Rom J Intern Med. 2009;47(2):109-21.
Pulmonary arterial hypertension is defined as a group of diseases characterised by a progressive increase in pulmonary vascular load, leading to marked increase in pulmonary artery pressure, right ventricular failure and premature death. Given the nonspecific nature of its early symptoms and signs, pulmonary arterial hypertension (PAH) is often diagnosed in its advanced stages. Although clinical assessment is essential when initially evaluating patients with suspected PAH, echocardiography is a key screening tool in the diagnostic algorithm, because, in comparison with invasive measurements, it has the advantages of being safe, portable, and repeatable. Therefore, Doppler echo is the modality most frequently used in pulmonary hypertension patients. Several echocardiographic techniques centered on the Doppler principle (both conventional Doppler parameters and tissue Doppler imaging) used in the assessment of PAH magnitude and its cardiac effects are presented in this paper. They provide important data on the severity, possible causes and consequences of pulmonary hypertension, both initially and during follow-up, therefore having the ability to estimate disease progression, prognosis, or to monitor therapeutic response. Doppler echocardiography allows to noninvasively estimate systolic pulmonary arterial pressure (SPAP), mean and end-diastolic pulmonary arterial pressure, as well as the quantification of right ventricular (RV) function and the evaluation of pulmonary vascular resistance (PVR).
肺动脉高压被定义为一组以肺血管负荷逐渐增加为特征的疾病，导致肺动脉压力显著升高、右心衰竭和过早死亡。鉴于其早期症状和体征的非特异性，肺动脉高压（PAH）往往在晚期才被诊断出来。虽然在初步评估疑似PAH患者时临床评估至关重要，但超声心动图是诊断流程中的关键筛查工具，因为与侵入性测量相比，它具有安全、便携和可重复的优点。因此，多普勒超声是肺动脉高压患者最常用的检查方式。本文介绍了几种以多普勒原理为中心的超声心动图技术（包括传统多普勒参数和组织多普勒成像），用于评估PAH的严重程度及其对心脏的影响。它们在初始阶段和随访期间都能提供有关肺动脉高压严重程度、可能病因和后果的重要数据，因此有能力估计疾病进展、预后或监测治疗反应。多普勒超声心动图能够无创地估计收缩期肺动脉压（SPAP）、平均和舒张末期肺动脉压，以及量化右心室（RV）功能和评估肺血管阻力（PVR）。
