Kambe T, Yokoi K, Itoh K, Nanki M, Matsubara T, Yanagisawa K, Hibi N, Nishimura K, Ichimiya S
J Cardiogr. 1982 Jun;12(2):523-34.
To investigate the localization of tricuspid regurgitant flow in Ebstein's anomaly, pulsed Doppler echocardiography (PDE) was performed on nine patients with or without associated cardiac lesions. The equipment used was characterized by the real time frequency analysis of Doppler signals obtained from the sampling sites confirmed on the cross-sectional images. We employed the apical four-chamber view or right ventricular inflow view in order to facilitate the sampling of Doppler signals from the three-sided heart chambers of this lesion. Doppler signals were recorded from several points in the functional right ventricle, atrialized right ventricle and right atrium. The PDE recording was made in conjunction with M-mode echocardiography at a paper speed of 50 mm per second. In eight of the nine patients, a systolic disturbed flow of wide band pattern was maximally located in the atrialized right ventricle in the vicinity of the tricuspid valve leaflets and had a delayed onset, which were seemed to be the findings characteristic of tricuspid regurgitation in Ebstein's anomaly. In the remaining one, a turbulent flow due to this lesion was obscured by a systolic jet of the associated ventricular septal defect in the vicinity of the tricuspid valve leaflet. In the right atrium, no disturbed flow of wide band pattern existed or only a faint abnormal blood flow was observed during systole. In the functional right ventricle, a smooth blood flow of the right ventricular inflow was recognized in diastole. In contrast, 15 patients with secondary tricuspid regurgitation revealed a holosystolic disturbed flow of wide band pattern maximally in the right atrium in the vicinity of the tricuspid valve leaflets. In eight healthy subjects, there was no systolic disturbed flow in the right atrium. Pulsed Doppler technique combined with two-dimensional echocardiography is thought useful to detect the localization of the disturbed flow in Ebstein's anomaly, thus contributing to the differentiation of various causes of tricuspid regurgitation.
为研究埃布斯坦畸形中三尖瓣反流的血流定位，对9例有或无相关心脏病变的患者进行了脉冲多普勒超声心动图（PDE）检查。所用设备的特点是对从横断面图像上确认的采样部位获得的多普勒信号进行实时频率分析。我们采用心尖四腔心切面或右心室流入道切面，以便于从该病变的三侧心腔采集多普勒信号。从功能性右心室、房化右心室和右心房的多个点记录多普勒信号。PDE记录与M型超声心动图同步进行，纸速为每秒50毫米。9例患者中有8例，宽带型收缩期紊乱血流最大位于房化右心室靠近三尖瓣叶处，且起始延迟，这似乎是埃布斯坦畸形中三尖瓣反流的特征性表现。在其余1例患者中，该病变导致的湍流被三尖瓣叶附近相关室间隔缺损的收缩期射流掩盖。在右心房，不存在宽带型紊乱血流，或仅在收缩期观察到微弱的异常血流。在功能性右心室，舒张期可识别出右心室流入道的平稳血流。相比之下，15例继发性三尖瓣反流患者显示全收缩期宽带型紊乱血流最大位于右心房靠近三尖瓣叶处。在8名健康受试者中，右心房无收缩期紊乱血流。脉冲多普勒技术结合二维超声心动图被认为有助于检测埃布斯坦畸形中紊乱血流的定位，从而有助于鉴别三尖瓣反流的各种病因。
