多普勒组织成像可对因先天性心内分流导致肺动脉高压的儿童的肺动脉压进行评估。

Doppler tissue imaging provides an estimate of pulmonary arterial pressure in children with pulmonary hypertension due to congenital intracardiac shunts.

作者信息

Cevik Ayhan, Kula Serdar, Olgunturk Rana, Saylan Berna, Pektas Ayhan, Oguz Deniz, Tunaoglu Sedef

机构信息

Department of Pediatric Cardiology, Gazi University Medical Faculty Hospital, Ankara, Turkey.

出版信息

Congenit Heart Dis. 2013 Nov-Dec;8(6):527-34. doi: 10.1111/chd.12030. Epub 2012 Dec 27.

DOI:10.1111/chd.12030

PMID:23280192

Abstract

OBJECTIVE

The aim of this study is to determine the relationship between the cardiac catheterization findings and pulsed-wave (PW) Doppler and Doppler tissue imaging (DTI) in pulmonary arterial hypertension patients with congenital heart disease with intracardiac shunts.

DESIGN AND PATIENTS

The present study aims to determine the relationship between the cardiac catheterization findings and PW Doppler and Doppler tissue imaging (DTI) in patients who have pulmonary arterial hypertension patients due to congenital heart disease with intracardiac shunts. Echocardiographic measurements were performed at the catheter angiography laboratory with concurrent catheterization. Left and right ventricle inflow velocities were recorded with PW Doppler and DTI studies. Maximum tricuspid regurgitation velocity (TS) was recorded in cases with measurable levels by continuous-wave Doppler. Moreover, the correlations among the echocardiographic values and invasive hemodynamic measures such as systolic pulmonary arterial pressure (PAPsystolic), mean pulmonary arterial pressure (PAPmean), diastolic pulmonary arterial pressure (PAPdiastolic) and pulmonary vascular resistance index (PVRI) were evaluated.

RESULTS

A negative correlation was found between TE'/TA' and PAPsystolic, PAPdiastolic and PAPmean (P = 0.008, r = -0.480; P = 0.001, r = -0.584; P = 0.001, r = -0.567, respectively). ME/ME' was also found to be negatively correlated with PAPdiastolic, PAPmean and PVRI (P = 0.002, r = -0.556; P = 0.005, r = -0.502; P = 0.027, r = -0.411, respectively). The concurrent use of TE'/TA' (cut-off value <2.6) and TS had a sensitivity of 79% and a specificity of 93% for distinguishing between patients with healthy controls.

CONCLUSION

When used in conjunction with conventional methods, TE'/TA' has the highest sensitivity and specificity in distinguishing between patients and healthy controls.

摘要

目的

本研究旨在确定先天性心脏病合并心内分流的肺动脉高压患者的心导管检查结果与脉冲波（PW）多普勒及多普勒组织成像（DTI）之间的关系。

设计与患者

本研究旨在确定因先天性心脏病合并心内分流而患有肺动脉高压的患者的心导管检查结果与PW多普勒及多普勒组织成像（DTI）之间的关系。在导管血管造影实验室同步进行心导管检查时进行超声心动图测量。通过PW多普勒和DTI研究记录左、右心室流入速度。通过连续波多普勒记录可测量水平病例的最大三尖瓣反流速度（TS）。此外，评估超声心动图值与收缩期肺动脉压（PAPsystolic）、平均肺动脉压（PAPmean）、舒张期肺动脉压（PAPdiastolic）和肺血管阻力指数（PVRI）等有创血流动力学测量值之间的相关性。

结果

发现TE'/TA'与PAPsystolic、PAPdiastolic和PAPmean之间呈负相关（分别为P = 0.008，r = -0.480；P = 0.001，r = -0.584；P = 0.001，r = -0.567）。还发现ME/ME'与PAPdiastolic、PAPmean和PVRI呈负相关（分别为P = 0.002，r = -0.556；P = 0.005，r = -0.502；P = 0.027，r = -0.411）。联合使用TE'/TA'（临界值<2.6）和TS区分患者与健康对照的敏感性为79%，特异性为93%。