Stojnić B, Pavlović P, Ponomarev D, Aleksandrov R, Prcović M
Department of Cardiology, Military Medical Academy, Belgrade, Yugoslavia.
Pediatr Cardiol. 1995 Jan-Feb;16(1):6-11. doi: 10.1007/BF02310326.
Pulsed Doppler echocardiographic and hemodynamic examinations were performed in 31 patients (mean age 17.8 years) with isolated ventricular septal defect (VSD). Three groups were studied: group I (n = 6) patients had severe pulmonary vascular obstructive disease (PVOD); group II (n = 12) patients had pulmonary hypertension (PH) without severe PVOD; group III (n = 13) patients had no PH. Bidirectional shunting was detected in 9 VSD patients (6 in group I and 3 in group II). Patients with low to moderately elevated right ventricular pressures demonstrated left-to-right shunting across the defect throughout the cardiac cycle. When systolic pressure in the right ventricle reached approximately 60% of the left ventricular pressure, right-to-left shunting occurred across the defect during early and mid diastole. However, in patients with Eisenmenger syndrome (group I) the right-to-left shunting occurred during late systole with continuation during the early and mid diastolic period. The earlier occurrence of right-to-left shunting (index < 0.5 second) signifies the presence of severe PVOD.
对31例（平均年龄17.8岁）单纯室间隔缺损（VSD）患者进行了脉冲多普勒超声心动图和血流动力学检查。研究分为三组：第一组（n = 6）患者有严重的肺血管阻塞性疾病（PVOD）；第二组（n = 12）患者有肺动脉高压（PH）但无严重PVOD；第三组（n = 13）患者无PH。在9例VSD患者中检测到双向分流（第一组6例，第二组3例）。右心室压力轻度至中度升高的患者在整个心动周期中均表现为经缺损的左向右分流。当右心室收缩压达到左心室压力的约60%时，在舒张早期和中期经缺损出现右向左分流。然而，艾森曼格综合征患者（第一组）的右向左分流发生在收缩晚期，并在舒张早期和中期持续存在。右向左分流的较早出现（指数<0.5秒）表明存在严重的PVOD。
