Nishimura R A, Tajik A
Herz. 1986 Oct;11(5):283-90.
With Doppler echocardiography, through assessment of the velocity profile of flow in the region of stenoses, regurgitant lesions or shunts the pressure difference between two cardiac chambers or a cardiac chamber and great vessel can be calculated, using the Bernoulli equation. If the pressure in one chamber is known from clinical parameters, then the pressure in the second chamber can be estimated. In stenosis of the left ventricular outflow tract, the left ventricular systolic pressure can be calculated as the sum of the pressure difference between the left ventricle and aorta during systole and the cuff blood pressure. In right ventricular outflow tract obstruction, the velocity of blood flow can be used to derive the pressure gradient between the right ventricle and pulmonary artery during systole and, if the right ventricular systolic pressure is known, the pulmonary artery pressure can be estimated. This method is applicable in valvular and supravalvular stenoses, as well as for pulmonary artery bands or right ventricular-pulmonary artery conduits. If the right atrial pressure is known or estimated clinically as the jugular venous pressure, the right ventricular systolic pressure can be calculated; in the absence of right ventricular outflow tract obstruction from the velocity of a tricuspid regurgitation jet, this will approximate pulmonary artery systolic pressure. Further parameters for evaluation of pulmonary artery pressure are the isovolumetric right ventricular relaxation time or the relaxation time index (Burstin method) and the preejection period, acceleration time and right ventricular ejection time as derived from the pulmonary artery velocity profile.(ABSTRACT TRUNCATED AT 250 WORDS)
通过多普勒超声心动图,通过评估狭窄、反流性病变或分流区域的血流速度剖面,利用伯努利方程可计算两个心腔或一个心腔与大血管之间的压力差。如果根据临床参数已知一个心腔的压力,那么就可以估算第二个心腔的压力。在左心室流出道狭窄时,左心室收缩压可计算为收缩期左心室与主动脉之间的压力差与袖带血压之和。在右心室流出道梗阻时,血流速度可用于得出收缩期右心室与肺动脉之间的压力梯度,并且,如果已知右心室收缩压,就可以估算肺动脉压力。该方法适用于瓣膜性和瓣膜上狭窄,以及肺动脉束带或右心室-肺动脉导管。如果临床上已知或根据颈静脉压估算出右心房压力,就可以计算右心室收缩压;在没有右心室流出道梗阻的情况下,根据三尖瓣反流射流的速度,这将近似肺动脉收缩压。评估肺动脉压力的其他参数是等容右心室舒张时间或舒张时间指数(布尔斯坦法)以及射血前期、加速时间和从肺动脉速度剖面得出的右心室射血时间。(摘要截取自250词)