Zeiher A M, Bonzel T, Wollschläger H, Kasper W, Just H
Z Kardiol. 1985 Nov;74(11):656-61.
The directional analysis of contrast echographic flow lines is routinely used for tricuspid insufficiency diagnosis. The value of this noninvasive technique for the assessment of pulmonic regurgitation is not yet established. Therefore we evaluated the contrast M-mode echocardiograms at the pulmonary valve in 55 patients. Echographic contrast was obtained by injection of 6-8 ml of indocyanin-saline solution into an antecubital vein. In all 5 patients with documented pulmonic insufficiency (3 patients after repair of tetralogy of Fallot, one with pulmonic endocarditis, one posttraumatic) typical diastolic retrograde directed flow lines crossing the pulmonary valve were recorded. In addition, 6 of 18 patients with primary or secondary pulmonary hypertension exhibited early to middiastolic retrograde flow lines at the pulmonary valve. In contrast, none of the normals (N = 13), and none of 19 patients with various cardiac diseases but unaffected pulmonary valve and normal pulmonary artery pressure, had contrast echographic evidence of pulmonary insufficiency. There were distinctive differences between the contrast flow patterns of the patients with organic pulmonary insufficiency and patients with functional pulmonic regurgitation due to pulmonary hypertension. It is concluded that the directional analysis of contrast echographic flow lines at the pulmonary valve allows a sensitive assessment of pulmonary regurgitation using standard echocardiographic equipment.
对比超声心动图血流线的方向分析常用于三尖瓣关闭不全的诊断。这种非侵入性技术在评估肺动脉瓣反流方面的价值尚未确立。因此，我们对55例患者的肺动脉瓣对比M型超声心动图进行了评估。通过将6 - 8毫升吲哚菁绿盐水溶液注入肘前静脉获得超声造影。在所有5例有记录的肺动脉瓣关闭不全患者中（3例法洛四联症修复术后患者，1例肺动脉瓣心内膜炎患者，1例创伤后患者），均记录到典型的舒张期逆向血流线穿过肺动脉瓣。此外，18例原发性或继发性肺动脉高压患者中有6例在肺动脉瓣处出现舒张早期至中期逆向血流线。相比之下，13例正常人以及19例患有各种心脏病但肺动脉瓣未受影响且肺动脉压正常的患者中，均无肺动脉瓣关闭不全的对比超声心动图证据。器质性肺动脉瓣关闭不全患者与因肺动脉高压导致的功能性肺动脉瓣反流患者的对比血流模式存在显著差异。结论是，使用标准超声心动图设备对肺动脉瓣对比超声心动图血流线进行方向分析可对肺动脉瓣反流进行敏感评估。
