Dabestani A, Mahan G, Gardin J M, Takenaka K, Burn C, Allfie A, Henry W L
Am J Cardiol. 1987 Mar 1;59(6):662-8. doi: 10.1016/0002-9149(87)91189-1.
Pulsed Doppler echocardiography was used to examine the relation between pulmonary valve motion and pulmonary artery (PA) flow velocity patterns in 39 adults. In 16 patients with normal PA pressure (mean pressure less than 20 mm Hg), PA flow velocity accelerated slowly to a peak flow velocity at midsystole (time to peak flow velocity, or acceleration time = 134 +/- 20 ms [mean +/- standard deviation]), followed by a slow deceleration to the end of ejection, producing a "dome-like" appearance. In contrast, in 23 patients with elevated PA pressure (mean pressure 20 mm Hg or more), flow velocity accelerated rapidly to a peak flow velocity in early systole (acceleration time = 88 +/- 25 ms, p less than 0.01), followed by rapid flow velocity deceleration to a nadir in midsystole. In 13 of these patients, a transient increase in flow velocity occurred in late systole, producing a "spike and dome" appearance. In patients with an acceleration time of 120 ms or less, there was a negative linear correlation with mean PA pressure, expressed by the equation: mean PA pressure = 90 - (0.62 X acceleration time). The standard error of the estimate was 8.3 mm Hg. A similar negative linear correlation was found between PA acceleration time and total pulmonary resistance. Using a PA acceleration time of 100 ms or less resulted in a 78% sensitivity and a 100% specificity for detection of elevated PA pressure. Although this Doppler method cannot precisely estimate PA pressure, it can be helpful in separating patients with normal pressure from those with elevated PA pressure.
采用脉冲多普勒超声心动图检查了39例成年人的肺动脉瓣运动与肺动脉（PA）血流速度模式之间的关系。在16例肺动脉压力正常（平均压力小于20 mmHg）的患者中，肺动脉血流速度在收缩中期缓慢加速至峰值流速（达到峰值流速的时间，即加速时间 = 134±20毫秒[平均值±标准差]），随后在射血末期缓慢减速，呈现出“圆顶状”外观。相比之下，在23例肺动脉压力升高（平均压力20 mmHg或更高）的患者中，血流速度在收缩早期迅速加速至峰值流速（加速时间 = 88±25毫秒，p<0.01），随后在收缩中期迅速减速至最低点。在其中13例患者中，收缩晚期血流速度出现短暂增加，呈现出“尖峰和圆顶”外观。在加速时间为120毫秒或更短的患者中，与平均肺动脉压力呈负线性相关，用方程表示为：平均肺动脉压力 = 90 -（0.62×加速时间）。估计的标准误差为8.3 mmHg。在肺动脉加速时间与总肺阻力之间也发现了类似的负线性相关。使用100毫秒或更短的肺动脉加速时间来检测肺动脉压力升高，其敏感性为78%，特异性为100%。虽然这种多普勒方法不能精确估计肺动脉压力，但有助于区分肺动脉压力正常的患者和肺动脉压力升高的患者。
