Torbicki A, Hawrylkiewicz I, Zielinski J
Department of Hypertension and Angiology, Academy of Medicine, Warsaw, Poland.
Bull Eur Physiopathol Respir. 1987 May-Jun;23(3):233-9.
Pulmonary valve echography was technically possible in 44 of 120 patients with chronic lung disease (CLD). Mean pulmonary arterial pressure (Ppa) was significantly correlated with right ventricular isovolumetric relaxation ratio (RVIRT/RVET) as derived from the movement of cusps in valves of the right heart (r = 0.842; p less than 0.001). Prolonged RVIRT was found in 52% of patients with Ppa greater than 20 mmHg and in all ten patients with Ppa greater than 35 mmHg. Other echographic signs, including abnormal right ventricular systolic time intervals (STI), 'a' wave amplitude, right to left ventricular ratio (RV/LV) and interventricular septum diastolic bulging (IVS-B), were less sensitive, but found more often; when higher Ppa was recorded at catheterization in a given patient (r = 0.869; p less than 0.001). Approximate echographic estimation of Ppa in patients with chronic lung disease is possible if right ventricular systolic and diastolic time intervals can be measured and if abnormalities in right ventricular dimensions, interventricular septum motion and pulmonary valve echogram are considered. In contrast to pulmonary fibrosis, technical problems in adequate visualization of right heart valves in chronic obstructive lung disease limit the use of M-mode echo assessment of Ppa to a clinically unacceptable 22% of subjects.
在120例慢性肺病（CLD）患者中，有44例在技术上可行肺动脉瓣超声心动图检查。平均肺动脉压（Ppa）与右心室等容舒张比（RVIRT/RVET）显著相关，该比值由右心瓣膜瓣叶运动得出（r = 0.842；p < 0.001）。在Ppa大于20 mmHg的患者中，52%发现RVIRT延长，在Ppa大于35 mmHg的所有10例患者中均发现RVIRT延长。其他超声心动图征象，包括右心室收缩时间间期（STI）异常、“a”波振幅、右心室与左心室比值（RV/LV）以及室间隔舒张期膨出（IVS-B），敏感性较低，但发现频率更高；当在特定患者中通过心导管检查记录到更高的Ppa时（r = 0.869；p < 0.001）。如果能够测量右心室收缩和舒张时间间期，并且考虑右心室大小、室间隔运动和肺动脉瓣超声心动图的异常情况，那么对慢性肺病患者的Ppa进行近似的超声心动图估算是可行的。与肺纤维化不同，慢性阻塞性肺病患者右心瓣膜充分可视化存在技术问题，使得M型超声心动图对Ppa的评估在临床上仅适用于22%的受试者，这一比例令人难以接受。
