Cardiology Department, Bern University Hospital (Inselspital), Bern, Switzerland.
Pulmonology Department, Zurich University Hospital (USZ), Zurich, Switzerland.
Swiss Med Wkly. 2021 Jun 7;151:w20486. doi: 10.4414/smw.2021.20486. eCollection 2021 May 24.
Doppler echocardiography is widely used in everyday clinical practice for the detection of pulmonary hypertension (PH) in symptomatic patients and in populations particularly at risk of pulmonary arterial hypertension (PAH). It allows accurate estimation of systolic pulmonary arterial pressure but may lack precision in particular situations. In addition, echocardiography can help to distinguish between pre- and post-capillary PH and is a very good tool to evaluate right ventricular systolic function, which is of great prognostic interest in PAH. This article reviews the current knowledge about methodologic aspects of assessing pulmonary pressure and PH origin by echo, including a discussion about abnormal thresholds. It also details advanced techniques like right ventricular strain imaging and new concepts like right ventricle – pulmonary artery coupling evaluation that have become “matured” enough to be definitely brought to routine evaluation.
超声心动图在日常临床实践中被广泛用于检测有症状的患者和有肺动脉高压（PAH）风险的人群中的肺动脉高压（PH）。它可以准确估计收缩期肺动脉压，但在某些特定情况下可能缺乏准确性。此外，超声心动图有助于区分毛细血管前和毛细血管后 PH，是评估右心室收缩功能的非常好的工具，在 PAH 中具有重要的预后意义。本文综述了目前关于通过超声心动图评估肺压和 PH 起源的方法学方面的知识，包括对异常阈值的讨论。它还详细介绍了右心室应变成像等先进技术和右心室-肺动脉耦联评估等新概念，这些技术已经足够成熟，可以纳入常规评估。
