Vazquez de Prada J A, Ruano J, Martin-Duran R, Larman M, Zueco J, Ortiz de Murua J A, Torres A, Figueroa A
Int J Cardiol. 1987 Aug;16(2):177-84. doi: 10.1016/0167-5273(87)90249-x.
We evaluated the accuracy of continuous wave Doppler for estimating pulmonary arterial systolic pressure in patients with tricuspid regurgitation. Of 44 patients with a variety of cardiac disorders, 39 (89%) had Doppler-detected tricuspid regurgitation. Adequate spectral profiles of the flow signals were obtained in 34 of them (87%), representing 77% of the entire group. Continuous wave Doppler ultrasound was used to measure the maximum velocity of the regurgitant jet, and by applying the modified Bernoulli equation, the systolic pressure gradient between the right ventricle and the right atrium was calculated. Pulmonary arterial systolic pressure was estimated by adding the transtricuspid gradient to the mean right atrial pressure, and correlated well with catheterization values (r = 0.96). The correlation coefficient was not significantly modified if mean right atrial pressures were excluded in the calculations (r = 0.91). Continuous wave Doppler constitutes a sensitive method for the detection of tricuspid regurgitation. The method using the tricuspid gradient provides an accurate estimation of pulmonary arterial systolic pressure. Combined with other available methods (pulsed wave Doppler), this noninvasive technique can yield information comparable with that obtained at catheterization.
我们评估了连续波多普勒在估计三尖瓣反流患者肺动脉收缩压方面的准确性。在44例患有各种心脏疾病的患者中，39例（89%）经多普勒检测发现有三尖瓣反流。其中34例（87%）获得了足够的血流信号频谱图，占整个研究组的77%。使用连续波多普勒超声测量反流束的最大速度，并应用改良的伯努利方程计算右心室与右心房之间的收缩期压力阶差。通过将经三尖瓣压力阶差与右心房平均压相加来估计肺动脉收缩压，其与心导管检查值相关性良好（r = 0.96）。如果在计算中排除右心房平均压，相关系数无显著改变（r = 0.91）。连续波多普勒是检测三尖瓣反流的一种敏感方法。利用三尖瓣压力阶差的方法可准确估计肺动脉收缩压。结合其他现有方法（脉冲波多普勒），这种非侵入性技术能够提供与心导管检查相当的信息。
