Morera J, Hoadley S D, Roland J M, Pasipoularides A, Darragh R, Gaitan G, Pieroni D R
Department of Cardiology, Children's Hospital, Buffalo, New York 14222.
Am J Cardiol. 1989 Apr 1;63(12):862-6. doi: 10.1016/0002-9149(89)90058-1.
This study describes a method for estimation of the ratio of pulmonary to systemic pressures by pulsed-wave Doppler echocardiography. Sixty-eight patients ages 1 day to 68 years who underwent cardiac catheterization had Doppler studies of the right and left ventricular outflows. Preejection period (PEP), ejection time (ET) and mean acceleration to peak velocity (ACCm) were measured on each waveform. The expression: F = (PEP x ACCm)/ET was calculated for right and left ventricular outflows as an index of the effects that the interaction between ventricular contraction and afterload has on the shape of the Doppler waveforms generated in each outflow. The quotient of (F for the right outflow)/(F for the left outflow), or waveform contour ratio, was used to express the degree of pressure-dependent variability between each subject's right and left ventricular outflow tracings. The waveform contour ratio was strikingly similar to the ratio of systolic pulmonary to systemic pressures and also closely correlated to the ratio of mean pressures. The product of waveform contour ratio and arm systolic pressure gave a consistently accurate estimate of systolic pulmonary pressures. It is concluded that the present method can be used successfully for the noninvasive assessment of pulmonary arterial pressures.
本研究描述了一种通过脉冲波多普勒超声心动图估算肺循环与体循环压力比值的方法。对68例年龄从1天至68岁接受心导管检查的患者进行了左右心室流出道的多普勒研究。在每个波形上测量射血前期（PEP）、射血时间（ET）和平均加速度至峰值速度（ACCm）。计算表达式：F =（PEP×ACCm）/ET，用于左右心室流出道，作为心室收缩与后负荷之间相互作用对每个流出道产生的多普勒波形形状影响的指标。（右流出道的F）/（左流出道的F）的商，即波形轮廓比，用于表示每个受试者左右心室流出道描记图之间压力依赖性变异性的程度。波形轮廓比与收缩期肺循环与体循环压力比值惊人地相似，并且也与平均压力比值密切相关。波形轮廓比与手臂收缩压的乘积始终能准确估算收缩期肺动脉压力。结论是，本方法可成功用于肺动脉压力的无创评估。
