Oswald-Mammosser M, Oswald T, Dickele M C, Nyankiye E, Ehrhart M, Weitzenblum E
Rev Mal Respir. 1987;4(2):77-84.
Right heart catheterisation (reference method) and M-mode echocardiography were performed in 90 patients with chronic respiratory failure (73 BPCO-chronic airflow obstruction and 17 non-BPCO). The aim of this study was to assess the place of echo-cardiography in the diagnosis and assessment of pulmonary arterial hypertension (HTAP) and/or right ventricular hypertrophy (HVD). The results are somewhat deceptive; first as reliable measurements were impossible in 20% of cases (due to airways distension), then because the sensibility of the method is only 75% (only 62.2% in the group with moderate HTAP with a mean pulmonary artery pressure (PAP) between 21 and 30 mmHg, where as the specificity was satisfactory (87.5%). The best coefficient of linear correlation was observed between the PAP and the end-diastolic diameter of the right ventricle (DTDVD) (r = 0.52; p less than 0.001). Such a correlation does not allow for a prediction of an exact level of PAP in individual cases. The combination of 3 non-invasive methods (ECG, Echo-cardiography and myocardial scintigraphy) allows for an excellent overall sensibility (91.7%) but to the detriment of the specificity (66.6% only).
对90例慢性呼吸衰竭患者（73例慢性气流阻塞性支气管炎和17例非慢性气流阻塞性支气管炎）进行了右心导管检查（参考方法）和M型超声心动图检查。本研究的目的是评估超声心动图在肺动脉高压（HTAP）和/或右心室肥厚（HVD）诊断及评估中的地位。结果有些误导性；首先，20%的病例无法进行可靠测量（由于气道扩张），其次，该方法的敏感性仅为75%（在平均肺动脉压（PAP）为21至30 mmHg的中度HTAP组中仅为62.2%），而特异性令人满意（87.5%）。观察到PAP与右心室舒张末期直径（DTDVD）之间的最佳线性相关系数（r = 0.52；p小于0.001）。这种相关性无法在个体病例中预测PAP的确切水平。三种非侵入性方法（心电图、超声心动图和心肌闪烁显像）联合使用可获得极佳的总体敏感性（91.7%），但特异性会降低（仅66.6%）。
