Dittrich H C, Nicod P H, Chow L C, Chappuis F P, Moser K M, Peterson K L
Cardiology Division, University of California Medical Center, San Diego 92103-1990.
J Am Coll Cardiol. 1988 May;11(5):937-43. doi: 10.1016/s0735-1097(98)90049-3.
To determine the changes in right heart hemodynamics and geometry early after surgery for chronic pulmonary hypertension due to large vessel thromboembolic occlusion, 30 patients were evaluated 8 +/- 8 days (mean +/- SD) before and 6 +/- 4 days after pulmonary thromboendarterectomy by two-dimensional echocardiography and right heart catheterization. Surgery resulted in an early significant improvement in hemodynamic variables including mean pulmonary artery pressure (48 +/- 12 to 28 +/- 8 mm Hg, p less than 0.001), right ventricular systolic pressure (76 +/- 20 to 47 +/- 15 mm Hg, p less than 0.001), pulmonary vascular resistance (935 +/- 620 to 278 +/- 252 dynes.s.cm-5, p less than 0.001) and cardiac index (2.0 +/- 0.5 to 2.9 +/- 0.6 liters/min per m2, p less than 0.001). Similarly, echocardiographic variables of right heart structures, which were well outside the normal range preoperatively, improved significantly early after thromboendarterectomy. These included diameters of the pulmonary artery (2.8 +/- 0.3 to 2.4 +/- 0.4 cm, p less than 0.001), inferior vena cava (2.9 +/- 0.6 to 2.2 +/- 0.4 cm, p less than 0.001) and right atrium (6.8 +/- 1.5 to 5.9 +/- 1.5 cm, p less than 0.001) as well as right ventricular short axis (4.5 +/- 0.8 to 3.7 +/- 0.8 cm, p less than 0.001) and long axis (8.7 +/- 0.9 to 8.1 +/- 0.9 cm, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定大血管血栓栓塞性闭塞所致慢性肺动脉高压手术后早期右心血流动力学和几何形态的变化，我们对30例患者在肺动脉血栓内膜剥脱术前8±8天（均值±标准差）和术后6±4天进行了二维超声心动图和右心导管检查评估。手术使血流动力学变量早期显著改善，包括平均肺动脉压（从48±12降至28±8 mmHg，p<0.001）、右心室收缩压（从76±20降至47±15 mmHg，p<0.001）、肺血管阻力（从935±620降至278±252 dynes·s·cm⁻⁵，p<0.001）和心脏指数（从2.0±0.5升至2.9±0.6升/分钟每平方米，p<0.001）。同样，术前远超出正常范围的右心结构超声心动图变量在血栓内膜剥脱术后早期也显著改善。这些变量包括肺动脉直径（从2.8±0.3降至2.4±0.4 cm，p<0.001）、下腔静脉直径（从2.9±0.6降至2.2±0.4 cm，p<0.001）和右心房直径（从6.8±1.5降至5.9±1.5 cm，p<0.001），以及右心室短轴（从4.5±0.8降至3.7±0.8 cm，p<0.001）和长轴（从8.7±0.9降至8.1±0.9 cm，p<0.001）。（摘要截断于250字）
