Rufino Nascimento L G, Dehant P, Jimenez M, Dequeker J L, Castela E, Choussat A
Rev Port Cardiol. 1989 Jan;8(1):35-40.
To correlate QP/QS ratio determined by echo-Doppler with that obtained by cardiac catheterization (oximetric method) performed within 48 hours, in children with isolated septal defects.
The QP/QS ratio was evaluated by pulsed and or continuous wave echo-Doppler in 50 children who were submitted within 48 hours to cardiac catheterization. All children had an intracardiac shunt (12 atrial septal defects--ASD; 26 ventricular septal defects--VSD and 12 atrio ventricular septal defects--AVDS). Identical measurements were performed in a group of 20 children without cardiac malformation--control group. To test inter-observer variability, all the measurement in 31 patients were repeated by a second observer. Pulmonary and aortic flow was calculated as: Q = A x V x ET x CF where, A is the valvular orifice area (cm2), V the mean flow velocity (cm/sec), ET the ejection time (sec) and CF the cardiac frequency (cycles/min). The Doppler beam-flow direction angle in the pulmonary (P) artery and ascending aorta (Ao) was less than 20 degrees. Results were correlated with those obtained by catheterization (oximetric method).
We obtained a fairly good correlation with both pulsed wave Doppler (n = 43; r = 0.88; p less than 0.001; y = 0.84x + 0.40) and continuous wave Doppler (n = 50; r = 0.91; p less than 0.001; y = 0.86x + 0.35) or with pulsed wave Doppler in the P artery and continuous wave Doppler in the Ao (n = 43; r = 0.92; p less than 0.001; y = 0.86x + 0.27). In the control group, QP/QS ratio was evaluated by echo-Doppler: pulsed wave Doppler at 1.05 +/- 0.15 (mean +/- DS); continuous wave Doppler at 1.05 +/- 0.12 and, pulsed wave Doppler in the P artery and continuous wave Doppler in the Ao at 1.03 +/- 0.12. There was no significant difference in all three groups to the normal range of 1.00 (p less than 0.01). Inter-observer variability was less than 5.5% (p less than 0.001).
Pulsed and/or continuous wave echo-Doppler measurements are a reliable noninvasive method in evaluating QP/QS ratio in children with isolated septal defects.
在患有单纯性房间隔缺损的儿童中，将超声多普勒测定的QP/QS比值与48小时内通过心导管检查（血氧测定法）获得的比值进行相关性分析。
对50名在48小时内接受心导管检查的儿童，采用脉冲波和/或连续波超声多普勒评估QP/QS比值。所有儿童均有心脏内分流（12例房间隔缺损——ASD；26例室间隔缺损——VSD；12例房室间隔缺损——AVSD）。在一组20名无心脏畸形的儿童——对照组中进行相同测量。为测试观察者间的变异性，由第二名观察者对31例患者的所有测量进行重复。肺循环和主动脉血流量计算如下：Q = A×V×ET×CF，其中，A为瓣膜口面积（cm²），V为平均血流速度（cm/秒），ET为射血时间（秒），CF为心率（次/分钟）。肺动脉（P）和升主动脉（Ao）中的多普勒束流方向角小于20度。结果与通过心导管检查（血氧测定法）获得的结果进行相关性分析。
我们发现，脉冲波多普勒（n = 43；r = 0.88；p＜0.001；y = 0.84x + 0.40）、连续波多普勒（n = 50；r = 0.91；p＜0.001；y = 0.86x + 0.35），或者肺动脉中的脉冲波多普勒和主动脉中的连续波多普勒（n = 43；r = 0.92；p＜0.001；y = 0.86x + 0.27）之间均具有相当好的相关性。在对照组中，通过超声多普勒评估QP/QS比值：脉冲波多普勒为1.05±0.15（均值±标准差）；连续波多普勒为1.05±0.12；肺动脉中的脉冲波多普勒和主动脉中的连续波多普勒为1.03±0.12。三组与正常范围1.00相比均无显著差异（p＜0.01）。观察者间变异性小于5.5%（p＜0.001）。
脉冲波和/或连续波超声多普勒测量是评估单纯性房间隔缺损患儿QP/QS比值的可靠无创方法。
