[Contrast echocardiographic evaluation of right ventricular filling profiles in patients with right ventricular volume or pressure overload].

UNLABELLED

Contrast echocardiographic examinations were performed to evaluate hemodynamic filling profiles in patients with right ventricular overload as well as in normal adults. The subjects were 15 cases of atrial septal defect (ASD) as a representative of right ventricular volume overload, 13 cases of mitral stenosis (MS) as a condition with right ventricular pressure overload and 15 cases of normal adults. M-mode contrast echocardiograms were recorded through the ultrasonic beam direction determined by two-dimensional echocardiograms as shown in Fig. 1.

RESULTS

1. In diastole, continuous rapid linear flow through the tricuspid valve orifice was observed in 11 patients with ASD, while biphasic rapid linear flow was noted in normal adults (control) and in patient with MS. 2) Maximum flow velocity (MFV) in early diastole and flow velocity in atrial contraction phase (AFV) were larger in cases with ASD than that of the control subjects. However, there was no difference in rapid filling time (RFT) between patients with ASD and MS. 3) The characteristic findings of tricuspid valve echoes in cases of ASD included increased valve opening velocity (TOV), decreased diastolic descent rate (TDDR), and high F point. These findings were correlated well with increased MFV and prolonged RFT. 4) MFV was decreased secondarily to the increment of pulmonary artery pressure. 5) Turbulent flow in the right-sided chamber was observed in patients with pulmonary hypertension. These results suggest that linear contrast echoes in the M-mode echocardiograms may be useful for the evaluation of flow velocity and flow profiles across the tricuspid valve orifice in patients with right ventricular volume or pressure overload.