Kronik G, Slany J, Moesslacher H
Circulation. 1979 Feb;59(2):372-8. doi: 10.1161/01.cir.59.2.372.
Contrast echocardiograms during normal quiet respiration and during the Valsalva maneuver were performed in 15 patients with atrial septal defect (ASD) by injecting saline solution into an antecubital vein. Contrast shunting (the appearance of contrast echoes in the left heart) was observed not only in four patients with severe pulmonary hypertension (group 2), but also in 11 patients with uncomplicated ASD (group 1). Contrast shunting was prominent in all group 2 patients. In group 1, contrast shunting was sometimes subtle and difficult to recognize, but at other times was very obvious and similar to the findings in group 2. Contrast shunting was generally more pronounced during the Valsalva maneuver than during normal respiration, although there were exceptions. The amount of contrast appearing in the left heart did not correlate with the size of the defect. Small right-to-left shunts which are clinically insignificant but detectable by contrast echocardiography are present, or can be provoked by the Valsalva maneuver, in most patients with ASD. Contrast echocardiography is a useful, noninvasive method to detect interatrial communication, even in acyanotic patients.
通过将盐水溶液注入肘前静脉，对15例房间隔缺损（ASD）患者在正常平静呼吸和瓦尔萨尔瓦动作期间进行了对比超声心动图检查。不仅在4例重度肺动脉高压患者（2组）中观察到对比剂分流（左心出现对比剂回声），在11例无并发症的ASD患者（1组）中也观察到了。2组所有患者的对比剂分流都很明显。在1组中，对比剂分流有时很细微，难以识别，但其他时候非常明显，与2组的表现相似。尽管有例外情况，但对比剂分流在瓦尔萨尔瓦动作期间通常比正常呼吸时更明显。左心出现的对比剂数量与缺损大小无关。大多数ASD患者存在临床上无意义但可通过对比超声心动图检测到的小的右向左分流，或者可由瓦尔萨尔瓦动作诱发。对比超声心动图是一种有用的非侵入性方法，即使对于无青紫的患者也能检测到心房水平的分流。
