Yoshikawa J, Yoshida K, Owaki T, Kato H, Yanagihara K, Takagi Y, Okumachi F, Baba K
Jpn Heart J. 1978 Jan;19(1):58-65. doi: 10.1536/ihj.19.58.
Eight patients with congenital pulmonary regurgitation documented by cardiac catheterization and angiography were studied by echocardiography. Echocardiographic features of the pulmonary valve observed in this condition included a) diastolic fluttering (5 cases), b) diastolic separation (2 cases), and c) increase of posterior motion during atrial systole (a wave). Maximum a wave depth exceeded the upper limit of the normal value in 2 cases and averaged 6.1 +/- 0.7 (standard error of the mean) mm. In addition, d) diastolic fluttering of the anterior tricuspid valve was seen in 5 cases and e) abnormal interventricular septal motion in 2 cases (one, paradoxical and the other, flat). Of these findings, the diastolic fluttering of the pulmonary valve, which results from the turbulent stream of blood in the outflow of the right ventricle striking the pulmonary valve, is pathognomonic for pulmonary regurgitation. Although the other findings are nonspecific, all patients had at least 1 of these 5 findings. Echocardiography, therefore, provides useful clues to the diagnosis of pulmonary regurgitation. Furthermore, echocardiography should be of use in differentiating congenital from functional pulmonary regurgitation and from aortic regurgitation.
对8例经心导管检查和血管造影证实为先天性肺动脉反流的患者进行了超声心动图研究。在此情况下观察到的肺动脉瓣超声心动图特征包括：a）舒张期扑动（5例），b）舒张期分离（2例），以及c）心房收缩期（a波）时后向运动增加。2例患者的a波最大深度超过正常值上限，平均为6.1±0.7（均值标准误）mm。此外，d）5例患者可见三尖瓣前叶舒张期扑动，e）2例患者存在室间隔运动异常（1例矛盾运动，另1例平坦运动）。在这些发现中，肺动脉瓣舒张期扑动是由右心室流出道内的血流湍流冲击肺动脉瓣所致，是肺动脉反流的特征性表现。虽然其他发现不具有特异性，但所有患者至少有这5种发现中的1种。因此，超声心动图为肺动脉反流的诊断提供了有用线索。此外，超声心动图在区分先天性与功能性肺动脉反流以及与主动脉反流方面应具有应用价值。
