Yoshida K, Yoshikawa J, Akasaka T, Shakudo M, Takao S, Shiratori K, Okumachi F, Koizumi K, Kato H, Fukaya T
Department of Cardiology, Kobe General Hospital.
J Cardiol. 1989 Mar;19(1):187-94.
Sixty-eight patients with severe tricuspid regurgitation proven by right ventriculography were examined using pulsed and continuous wave Doppler echocardiography and color Doppler flow imaging. Among the 68 patients, there was no tricuspid regurgitant murmur in 16 (24%) in whom laminar regurgitant flow signals were demonstrated by pulsed Doppler echocardiography. The area in which laminar flow was detected ranged from 8 to 46 mm2 (mean 19.5 +/- 9.8 mm2). The peak velocities in patients without regurgitant murmurs as measured by continuous wave Doppler echocardiography ranged from 1.1 to 1.9 m/sec (mean: 1.61 +/- 0.21 m/sec). Laminar regurgitant flow signals were obtained in six; and turbulent regurgitant flow signals in 46 of 52 patients with tricuspid regurgitant murmurs, and their peak velocities ranged from 1.7 to 5.1 m/sec (2.80 +/- 0.78 m/sec). The peak velocities of the regurgitant flow signals in patients without tricuspid regurgitant murmurs were significantly lower than those in patients with regurgitant murmurs (p less than 0.01). In six patients with laminar regurgitant flow signals and regurgitant murmurs, the areas of laminar flow signals ranged from 3 to 12 mm2 (mean 7.0 +/- 3.5 mm2) and were smaller than those of patients without regurgitant murmurs (p less than 0.001). A characteristic candle flame pattern of regurgitant flow signals was observed in all patients without murmurs. Thus, the absence of a tricuspid regurgitant murmur results from laminar regurgitant flow signals of low velocity and this is characterized by a candle flame pattern using color Doppler flow imaging.
对68例经右心室造影证实为重度三尖瓣反流的患者，采用脉冲和连续波多普勒超声心动图以及彩色多普勒血流成像进行检查。在这68例患者中，16例（24%）没有三尖瓣反流杂音，脉冲多普勒超声心动图显示这些患者存在层流反流信号。检测到层流的区域面积为8至46平方毫米（平均19.5±9.8平方毫米）。连续波多普勒超声心动图测量的无反流杂音患者的峰值流速为1.1至1.9米/秒（平均：1.61±0.21米/秒）。52例有三尖瓣反流杂音的患者中，6例获得层流反流信号，46例获得湍流反流信号，其峰值流速为1.7至5.1米/秒（2.80±0.78米/秒）。无三尖瓣反流杂音患者的反流信号峰值流速显著低于有反流杂音的患者（p<0.01）。6例有层流反流信号且有反流杂音的患者，层流信号区域面积为3至12平方毫米（平均7.0±3.5平方毫米），小于无反流杂音患者的层流信号区域面积（p<0.001）。在所有无杂音的患者中均观察到特征性的反流信号烛焰样形态。因此，无三尖瓣反流杂音是由低速层流反流信号所致，通过彩色多普勒血流成像其特征表现为烛焰样形态。
