Karp K, Holm S, Teien D, Backman C, Eriksson P
Department of Clinical Physiology, University Hospital of Northern Sweden, Umeå.
Clin Physiol. 1995 Mar;15(2):105-17. doi: 10.1111/j.1475-097x.1995.tb00435.x.
In patients with mitral regurgitation (MR), pulmonary venous systolic flow fraction (PVSFfr) recorded using pulsed Doppler transoesophageal echocardiography (TEE) was compared with PVSFfr in normal subjects, to angiographic grading and to haemodynamic parameters. PVSfr was calculated as the systolic flow velocity integral divided by total inflow integral. PVSfr is negative when systolic flow is reversed. Forty patients with MR were studied. PVSFfr < 0 was 100% sensitive for angiographic severe MR (specificity 83%). In 35 patents heart rate differed by 10 bpm or less between TEE and cath, either at rest or during stress. PVSFfr was correlated with angiographic grade (r = -0.69, P < 0.0001), with mean PCW (r = -0.61, P < 0.0001), with the v-wave (r = -0.72, P < 0.0001), with systolic blood pressure (r = 0.48, P < 0.005) and with left atrial diameter (r = -0.52, P < 0.005). Stepwise forward multiple linear regression analysis revealed the v-wave, angiographic grading and systolic blood pressure to be independent predictors of PVSFfr. PVSFfr differed in normal subjects, patients with 0-2+ and patients with 3-4+ regurgitation. PVSFfr is a valuable index in assessing mitral regurgitation. This index may be less dependent on equipment and operator than colour flow imaging.
在二尖瓣反流（MR）患者中，使用脉冲多普勒经食管超声心动图（TEE）记录的肺静脉收缩期血流分数（PVSFfr）与正常受试者的PVSFfr、血管造影分级以及血流动力学参数进行了比较。PVSfr通过收缩期血流速度积分除以总流入积分来计算。当收缩期血流反向时，PVSfr为负值。对40例MR患者进行了研究。PVSFfr < 0对血管造影显示的严重MR的敏感性为100%（特异性为83%）。在35例患者中，TEE和心导管检查时的心率在静息或应激状态下相差10次/分或更少。PVSFfr与血管造影分级相关（r = -0.69，P < 0.0001），与平均肺毛细血管楔压（r = -0.61，P < 0.0001）、v波（r = -0.72，P < 0.0001）、收缩压（r = 0.48，P < 0.005）以及左心房直径（r = -0.52，P < 0.005）相关。逐步向前多元线性回归分析显示，v波、血管造影分级和收缩压是PVSFfr的独立预测因素。正常受试者、反流程度为0 - 2+的患者和反流程度为3 - 4+的患者的PVSFfr存在差异。PVSFfr是评估二尖瓣反流的一个有价值的指标。该指标可能比彩色血流成像对设备和操作者的依赖性更小。
