[Evaluation of systolic motion of the pulmonic valve with special reference to pulmonary arterial pressure and flow velocity (author's transl)].

To predict pulmonary arterial pressure non-invasively, systolic motion of the pulmonic valve was evaluated in relation to flow velocity at the pulmonic valve measured by the electromagnetic catheter-tip flow velocity probe or by linear contrast echo. Seventy-five cases including 45 cases with pulmonary hypertension (PH) of mean pulmonary arterial pressure (PAP) above 25 mmHg were studied. On the basis of the presence and velocity of mid-systolic semi-closure, the reopening and fluttering of the PV, the systolic motion of the pulmonic valve was classified into the following 5 types: 1) rapid semi-closure followed by reopening, 2) rapid semi-closure without reopening, 3) slow semi-closure followed by slow reopening, 4) rough fluttering during whole systole, and 5) rapid opening without semi-closure. Results were as follows: (1) In all cases in which mean PAP was normal, PV motion could be classified as type 5, (2) In 45 PH cases, mean PAP was 50.2 +/- 8.3 mmHg in type 1, 38.4 +/- 5.5 mmHg type 5, mean PAP was 16.3 +/- 11.7 mmHg when 30 normal cases were added. Flow velocity at the PV orifice was maximum in type I and decreased in type 2, 3 and 4 in this order. In type 4, cardiac indices were minimum in all groups of pulmonary hypertension. In conclusion, 1) systolic pulmonic valve motion is of value to predict PAP, and 2) it was suggested that mid-systolic semi-closure of the PV is related to increase in flow velocity at the PV orifice.