Sullivan I D, Robinson P J, Wyse R K, Macartney F J, Deanfield J E
Int J Cardiol. 1986 Oct;13(1):69-80. doi: 10.1016/0167-5273(86)90080-x.
Continuous wave Doppler assessment of systolic pressure gradients was performed using a digital maximal frequency estimator in 118 consecutive infants and children with suspected ventricular outflow obstruction who were undergoing cardiac catheterisation. There was satisfactory correlation with measured systolic pressure gradients in most patients with isolated pulmonary valve stenosis, aortic stenosis or aortic coarctation. Important under-estimation of gradients, however, occurred frequently in patients with more complex lesions. In many of these, the stenotic jet was posteriorly located or obstruction to flow occurred at more than one level. Continuous wave Doppler assessment of outflow tract gradients should be interpreted with caution in complex congenital heart lesions. A low predicted gradient should not be relied upon in isolation for clinical decision making. On the other hand, demonstration of a large gradient by continuous wave Doppler ultrasound provides additional information which may obviate the need for invasive investigation.
在118例连续接受心导管检查且怀疑有室流出道梗阻的婴幼儿及儿童中，使用数字最大频率估计器进行了收缩压梯度的连续波多普勒评估。在大多数单纯肺动脉瓣狭窄、主动脉瓣狭窄或主动脉缩窄患者中，与测量的收缩压梯度有良好的相关性。然而，在病变较复杂的患者中，梯度经常被严重低估。在许多这类患者中，狭窄射流位于后方或在多个层面存在血流梗阻。对于复杂先天性心脏病病变，应谨慎解释流出道梯度的连续波多普勒评估结果。不应仅依靠低预测梯度来进行临床决策。另一方面，连续波多普勒超声显示出大梯度可提供额外信息，这可能无需进行侵入性检查。
