Kitabatake A, Inoue M, Asao M, Masuyama T, Tanouchi J, Morita T, Mishima M, Uematsu M, Shimazu T, Hori M, Abe H
Circulation. 1983 Aug;68(2):302-9. doi: 10.1161/01.cir.68.2.302.
We used a pulsed Doppler technique to examine the flow velocity pattern in the right ventricular outflow tract in 33 adults. In the patients with normal pulmonary artery pressure (mean pressure less than 20 mm Hg, 16 patients), ejection flow reached a peak level at midsystole (137 +/- 24 msec, mean +/- SD), producing a domelike contour of the flow velocity pattern during systole. In contrast, the flow velocity pattern in patients with pulmonary hypertension (mean pressure greater than or equal to 20 mm Hg, 17 patients) was demonstrated to accelerate rapidly and to reach a peak level sooner (97 +/- 20 msec, p less than .01); in 10 of the pulmonary hypertensive patients a secondary slower rise in flow velocity was observed during a deceleration, resulting in the midsystolic notching. The time to peak flow (acceleration time, AcT) and right ventricular ejection time (RVET) were measured from the flow velocity pattern. Either AcT or AcT/RVET decreased with increase in mean pulmonary artery pressure, and a very high correlation (r = -.90) was found between AcT/RVET and log10 (mean pulmonary artery pressure). The use of this technique permitted the noninvasive estimation of the pulmonary artery pressure.
我们采用脉冲多普勒技术对33名成年人右心室流出道的血流速度模式进行了检测。在肺动脉压力正常（平均压力小于20 mmHg，共16例患者）的患者中，射血血流在收缩中期达到峰值水平（137±24毫秒，平均值±标准差），在收缩期产生类似圆顶状的血流速度模式轮廓。相比之下，肺动脉高压患者（平均压力大于或等于20 mmHg，共17例患者）的血流速度模式被证明加速更快且更早达到峰值水平（97±20毫秒，p<0.01）；在10例肺动脉高压患者中，减速过程中观察到血流速度有一个继发性的缓慢上升，导致收缩中期出现切迹。从血流速度模式中测量出达到峰值血流的时间（加速时间，AcT）和右心室射血时间（RVET）。AcT或AcT/RVET均随着平均肺动脉压力的升高而降低，并且在AcT/RVET与log10（平均肺动脉压力）之间发现了非常高的相关性（r = -0.90）。这项技术的应用使得肺动脉压力的无创性估计成为可能。
