Schartl M, Schartl S, Disselhoff W, Lange L, Disselhoff M
Z Kardiol. 1982 May;71(5):370-6.
57 patients (age 2 to 79 years) with atrial septal defect and 28 patients (age 1 month to 60 years) with ventricular septal defect were examined to find out whether the 2-d-echo allows to predict the shunt flow and the hemodynamic parameters of the pulmonary system. In 96% of the patients with asd, the defect could be demonstrated in the subcostal view. In 68% of the patients with vsd, the defect was shown in the long axis or the subcostal view. There was a low correlation between the size of the defect and the quotient of pulmonary to systemic flow (for asd: r = 0.73; for vsd: r = 0.62). Also, the quotient of pulmonary to systemic flow related rather poorly to the quotient of pulmonary artery diameter to aortic diameter as determined in th short axis (for asdii: r = 0.75; for vsd: r = 0.73). Nor relation could be found between echocardiographic parameters and pulmonary artery pressure with one exception: if contrast-echocardiography revealed a right-to-left shunt in patients with vsd, the pulmonary pressure exceeded the systemic pressure by 50%. The results show that in patients with asd or vsd the hemodynamic situation cannot be exactly judged from echocardiographic findings alone. The consideration of several echocardiographic parameters, however, seems to allow a distinction between hemodynamically relevant and irrelevant defects, which might be helpful for clinical purposes. For patients with asd, a shunt volume of minor importance (Qp:Qs less than 1.5:1) is found if the defect does not exceed 35% of the atrial septum length and if the quotient of pulmonary to aortic diameter is less than 1. In patients with vsd, the demonstration of the defect itself and a quotient of pulmonary to aortic diameter larger than 1 means that a shunt volume with Qp:Qs greater than 1.5:1 can be expected. Unsatisfactory results concerning the pulmonary pressure are obtained even when applying the contrast-echocardiography.
对57例（年龄2至79岁）房间隔缺损患者和28例（年龄1个月至60岁）室间隔缺损患者进行了检查，以确定二维超声心动图是否能够预测分流流量和肺循环系统的血流动力学参数。在96%的房间隔缺损患者中，缺损可在肋下视图中显示。在68%的室间隔缺损患者中，缺损在长轴或肋下视图中显示。缺损大小与肺循环与体循环血流量之比之间的相关性较低（房间隔缺损：r = 0.73；室间隔缺损：r = 0.62）。此外，肺循环与体循环血流量之比与短轴中测定的肺动脉直径与主动脉直径之比的相关性也较差（房间隔缺损：r = 0.75；室间隔缺损：r = 0.73）。除了一个例外情况外，在超声心动图参数与肺动脉压力之间未发现相关性：如果在室间隔缺损患者中造影超声心动图显示右向左分流，则肺动脉压力超过体循环压力50%。结果表明，在房间隔缺损或室间隔缺损患者中，仅从超声心动图检查结果无法准确判断血流动力学情况。然而，综合考虑多个超声心动图参数似乎可以区分血流动力学相关和不相关的缺损，这可能对临床有帮助。对于房间隔缺损患者，如果缺损不超过房间隔长度的35%且肺动脉与主动脉直径之比小于1，则发现分流体积不太重要（Qp:Qs小于1.5:1）。对于室间隔缺损患者，缺损本身的显示以及肺动脉与主动脉直径之比大于1意味着可以预期分流体积Qp:Qs大于1.5:1。即使应用造影超声心动图，关于肺动脉压力的结果也不理想。
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