Rao P S
Int J Cardiol. 1987 May;15(2):195-203. doi: 10.1016/0167-5273(87)90315-9.
Good correlation between Doppler-derived and catheterization-measured pulmonary valvar pressure gradients has previously been reported. The purpose of this paper was to present two groups of patients who did not show such correlation, namely those with very severe stenosis and those measured immediately following balloon pulmonary valvoplasty. Twenty-two patients, aged 4 months to 20 years, in whom Doppler and catheterization pressure gradients were measured within 24 hours of each other were included in the study. There were 35 pairs of such data. The correlation coefficient for the entire group was 0.61 which improved to 0.91 when the five patients with severe stenosis (gradients of 94 to 190 mm Hg) and one patient with severe right ventricular infundibular stenosis immediately following balloon valvoplasty were excluded from analysis. Although the possibility exists, technical aspects of Doppler recording did not appear to be causing this lack of correlation. Cone-shaped spray formation rather than a focused jet in patients with extremely severe pulmonary stenosis may be postulated to be responsible for poor prediction by Doppler of catheterization gradient. Once these two groups of patients are excluded, there is excellent correlation between Doppler and catheterization gradients in patients with pulmonic stenosis.
先前已有报道称，经多普勒测量得出的肺动脉瓣压力阶差与心导管检查测量结果之间存在良好的相关性。本文的目的是介绍两组未显示出这种相关性的患者，即患有极重度狭窄的患者以及球囊肺动脉瓣成形术后立即进行测量的患者。本研究纳入了22例年龄在4个月至20岁之间的患者，这些患者在彼此24小时内进行了多普勒和心导管检查压力阶差测量。共有35组这样的数据。整个组的相关系数为0.61，当将5例重度狭窄（压力阶差为94至190 mmHg）的患者和1例球囊瓣膜成形术后立即出现重度右心室漏斗部狭窄的患者排除在分析之外时，相关系数提高到了0.91。尽管存在这种可能性，但多普勒记录的技术方面似乎并不是导致这种缺乏相关性的原因。对于极重度肺动脉狭窄患者，推测可能是锥形喷射形成而非聚焦射流导致多普勒对心导管检查压力阶差的预测不佳。一旦排除这两组患者，肺动脉狭窄患者的多普勒和心导管检查压力阶差之间就存在极好的相关性。
