Haskell R J, French W J
Department of Medicine, University of California, Los Angeles School of Medicine.
Am J Cardiol. 1988 Jan 1;61(1):136-41. doi: 10.1016/0002-9149(88)91319-7.
In most clinical conditions pulmonary artery (PA) wedge pressure accurately reflects left ventricular (LV) end-diastolic pressure. In the presence of mitral regurgitation (MR), large V waves can distort PA wedge pressure and result in incorrect estimation of LV end-diastolic pressure. In 52 patients with MR simultaneous measurement of PA wedge pressure or left atrial pressure and LV end-diastolic pressure was recorded. Twenty-one (40%) patients had large V waves (V wave greater than A wave by greater than 10 mm Hg, group 1), and 31 (60%) patients had small V waves (group 2). Group 1 had significantly higher V waves than group 2 (46 +/- 3 vs 21 +/- 2 mm Hg, p less than 0.001). The LV end-diastolic pressure was similar in both groups (21 +/- 2 vs 19 +/- 2 mm Hg, difference not significant). The mean PA wedge or left atrial pressure in group 1 (26 +/- 2 mm Hg) overestimated LV end-diastolic pressure (21 +/- 2 mm Hg) by 30% (p less than 0.01), but the trough of the X descent (20 +/- 2 mm Hg) was similar to the LV end-diastolic pressure. In group 2 patients with small V waves the mean PA wedge pressure was not significantly different from the LV end-diastolic pressure (16 +/- 2 vs 19 +/- 2 mm Hg, p = 0.06), but the trough of the X descent (13 +/- 2 mm Hg) underestimated LV end-diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
在大多数临床情况下，肺动脉（PA）楔压能准确反映左心室（LV）舒张末期压力。存在二尖瓣反流（MR）时，大V波会使PA楔压失真，导致对LV舒张末期压力的估计错误。对52例患有MR的患者同时测量了PA楔压或左心房压力以及LV舒张末期压力。21例（40%）患者有大V波（V波比A波大超过10 mmHg，第1组），31例（60%）患者有小V波（第2组）。第1组的V波明显高于第2组（46±3 vs 21±2 mmHg，p<0.001）。两组的LV舒张末期压力相似（21±2 vs 19±2 mmHg，差异不显著）。第1组的平均PA楔压或左心房压力（26±2 mmHg）高估LV舒张末期压力（21±2 mmHg）30%（p<0.01），但X降支的最低点（20±2 mmHg）与LV舒张末期压力相似。在第2组有小V波的患者中，平均PA楔压与LV舒张末期压力无显著差异（16±2 vs 19±2 mmHg，p = 0.06），但X降支的最低点（13±2 mmHg）低估了LV舒张末期压力。（摘要截选至250字）
