Murayama Michito, Mikami Taisei, Kaga Sanae, Okada Kazunori, Hioka Takuma, Masauzi Nobuo, Nakabachi Masahiro, Nishino Hisao, Yokoyama Shinobu, Nishida Mutsumi, Iwano Hiroyuki, Sakakibara Mamoru, Yamada Satoshi, Tsutsui Hiroyuki
Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan.
Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
Ultrasound Med Biol. 2017 May;43(5):958-966. doi: 10.1016/j.ultrasmedbio.2017.01.006. Epub 2017 Feb 27.
In our new echocardiographic method, pulmonary regurgitant velocity immediately before right atrial (RA) contraction is used to estimate pulmonary artery diastolic pressure (PADP) and mean PA wedge pressure (MPAWP). Our aim here was to compare the usefulness of this new method with that of the conventional method, which uses pulmonary regurgitant velocity at end diastole. We studied 55 consecutive patients who underwent echocardiography and right-sided heart catheterization. The pulmonary regurgitant velocities just before RA contraction and at end diastole were measured to obtain echocardiographic estimates of PADP (EPADP and EPADP, respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure. Compared with EPADP, EPADP correlated better with PADP (r = 0.87) and MPAWP (r = 0.80), and direct fixed biases were detected for EPADP but not for EPADP. The area under the receiver operating characteristic curve distinguishing patients with MPAWP ≥18 mm Hg was greater for EPADP (0.97) than for E/e' (0.94) and E/A (0.83). EPADP is thus useful in estimating PADP and MPAWP in patients with heart disease.
在我们新的超声心动图方法中，右心房（RA）收缩前的肺动脉反流速度用于估计肺动脉舒张压（PADP）和平均肺动脉楔压（MPAWP）。我们的目的是比较这种新方法与传统方法（使用舒张末期肺动脉反流速度）的有效性。我们研究了55例连续接受超声心动图检查和右侧心导管检查的患者。测量RA收缩前和舒张末期的肺动脉反流速度，通过将压力梯度加到超声心动图估计的RA压力上，分别获得PADP的超声心动图估计值（分别为EPADP和EPADP）。与EPADP相比，EPADP与PADP（r = 0.87）和MPAWP（r = 0.80）的相关性更好，并且检测到EPADP存在直接固定偏差，而EPADP没有。区分MPAWP≥18mmHg患者的受试者工作特征曲线下面积，EPADP（0.97）大于E/e'（0.94）和E/A（0.83）。因此EPADP在估计心脏病患者的PADP和MPAWP方面是有用的。
