Zeiher A M, Bonzel T, Wollschläger H, Hohnloser S, Hust M H, Just H
Am Heart J. 1986 Feb;111(2):297-306. doi: 10.1016/0002-8703(86)90143-2.
Although it has been shown that pulmonary flow velocity can be calculated from contrast M-mode echocardiographic tracings, the clinical value of this noninvasive method has not been established. We used contrast M-mode echocardiography to examine the flow velocity pattern at the pulmonary valve in 30 adults referred for diagnostic cardiac catheterization. In the 15 patients with normal pulmonary artery pressure (PAP) (mean pressure less than or equal to 20 mm Hg), midsystolic pulmonary flow velocity was significantly (p less than 0.001) higher (654 +/- 140 mm/sec) compared to the 15 patients with pulmonary hypertension (342 +/- 85 mm/sec, mean pressure greater than 20 mm Hg). Fourteen of the 15 patients with pulmonary hypertension exhibited an early systolic flow velocity peak, whereas all patients with normal PAP showed a dome-shaped systolic flow velocity profile with maximal flow velocity occurring in midsystole. A significant close correlation was found between the relative early to midsystolic flow velocity change and mean PAP (r = 0.96; p less than 0.001). Thus quantitative contrast M-mode echocardiography reliably differentiates patients with pulmonary hypertension from patients with normal mean PAP. In addition, this technique allows a noninvasive estimation of PAP.
尽管已经表明可以从对比M型超声心动图描记中计算肺血流速度，但这种非侵入性方法的临床价值尚未确立。我们使用对比M型超声心动图检查了30名因诊断性心导管插入术而就诊的成年人肺动脉瓣处的血流速度模式。在15名肺动脉压（PAP）正常（平均压小于或等于20mmHg）的患者中，与15名肺动脉高压患者（平均压大于20mmHg，血流速度为342±85mm/秒）相比，收缩中期肺血流速度显著更高（654±140mm/秒，p<0.001）。15名肺动脉高压患者中有14名表现出收缩早期血流速度峰值，而所有PAP正常的患者均表现出圆顶形的收缩期血流速度轮廓，最大血流速度出现在收缩中期。收缩早期至中期血流速度相对变化与平均PAP之间存在显著的密切相关性（r = 0.96；p<0.001）。因此，定量对比M型超声心动图能够可靠地将肺动脉高压患者与平均PAP正常的患者区分开来。此外，该技术还能对PAP进行非侵入性估计。
