Yoshida K, Yoshikawa J, Kato H, Yanagihara K, Okumachi F, Koizumi K, Shiratori K, Asaka T, Suzuki K, Inanami H
J Cardiogr. 1985 Dec;15(4):1157-69.
Hepatic vein flow can be reliably measured because Doppler sampling volumes are easily oriented parallel with the course of the hepatic vein. In this study, the relationship between the Doppler signal in the hepatic vein and the external jugular vein pulse was evaluated, and the contribution of the Doppler echocardiography to the quantitative diagnosis of tricuspid regurgitation was also assessed. The subjects consisted of five healthy persons, four patients with lone atrial fibrillation, 27 patients who underwent cardiac surgery, and 34 patients with tricuspid regurgitation. The severity of the regurgitation was judged by right ventriculography and inferior caval angiography. The pattern of the Doppler hepatic vein flow mimicked that of the jugular phlebogram in each patient. The normal hepatic vein flow consisted of two forward flows toward the heart; one in systole; the other, in diastole, and one retrograde flow toward the liver during atrial contraction. In patients with lone atrial fibrillation, a systolic backward flow toward the liver or a decrease in the systolic forward flow was observed, though there was no tricuspid regurgitation. In patients who had cardiac surgery, a systolic backward flow toward the liver or a decrease in the systolic forward flow was usual. However, a prominent systolic backward flow toward the liver was observed in patients with severe tricuspid regurgitation, and a decreased systolic forward flow toward the heart was observed in patients with moderate tricuspid regurgitation in sinus rhythm. We concluded that Doppler measurement of hepatic vein flow does not contribute to the diagnosis of tricuspid regurgitation in the presence of atrial fibrillation or in postoperative conditions, but that it is useful in identifying severe tricuspid regurgitation.
肝静脉血流能够可靠地测量，因为多普勒取样容积很容易与肝静脉走行平行定位。在本研究中，评估了肝静脉中的多普勒信号与颈外静脉搏动之间的关系，并且还评估了多普勒超声心动图对三尖瓣反流定量诊断的贡献。研究对象包括5名健康人、4名单纯性心房颤动患者、27名接受心脏手术的患者以及34名三尖瓣反流患者。反流的严重程度通过右心室造影和下腔静脉造影来判断。每位患者的多普勒肝静脉血流模式都与颈静脉搏动图相似。正常的肝静脉血流包括两个朝向心脏的正向血流，一个在收缩期，另一个在舒张期，以及一个在心房收缩期朝向肝脏的逆向血流。在单纯性心房颤动患者中，尽管没有三尖瓣反流，但观察到有朝向肝脏的收缩期逆向血流或收缩期正向血流减少。在接受心脏手术的患者中，朝向肝脏的收缩期逆向血流或收缩期正向血流减少是常见的。然而，在严重三尖瓣反流患者中观察到有明显的朝向肝脏的收缩期逆向血流，在窦性心律的中度三尖瓣反流患者中观察到有朝向心脏的收缩期正向血流减少。我们得出结论，在存在心房颤动或术后情况下，肝静脉血流的多普勒测量对三尖瓣反流的诊断没有帮助，但它在识别严重三尖瓣反流方面是有用的。
