Barbant S D, Redberg R F, Tucker K J, Chatterjee K, DeMarco T, Foster E, Schiller N B
Cardiovascular Research Institute, University of California, San Francisco 94143, USA.
Am Heart J. 1995 Jun;129(6):1185-92. doi: 10.1016/0002-8703(95)90402-6.
This study was designed to test the hypothesis that pulmonary artery pressure at rest and during exercise differs between patients with a transplanted heart and normal subjects and to determine the mechanisms responsible for the difference. Twenty-one patients who had undergone heart transplantation 1.5 to 27 months earlier without current evidence of acute cardiac rejection and 25 normal subjects were studied by exercise Doppler echocardiography. Systolic pulmonary artery pressure was higher at baseline in heart transplant patients than in normal subjects, at 31.6 +/- 9 mm Hg (mean +/- SD) versus 22.5 +/- 4, respectively (p = 0.0001). The increase in systolic pulmonary artery pressure with exercise was 1.4 times higher in heart transplant patients and correlated with pretransplantation pulmonary vascular resistances (r = 0.55; p = 0.01). In contrast, cardiac index at baseline or during exercise did not differ between the two groups. Diastolic parameters and ejection fraction at baseline or during exercise did not correlate with systolic pulmonary artery pressure. In conclusion, Doppler exercise echocardiography offers an alternative, safe method hemodynamic study of the transplanted heart. Although an abnormal increase in left ventricular filling pressure with exercise has been well documented, further studies are needed to investigate and characterize potential abnormalities in pulmonary vascular tone in the transplanted heart.
心脏移植患者与正常受试者静息及运动时的肺动脉压存在差异，并确定造成这种差异的机制。对21例在1.5至27个月前接受心脏移植且目前无急性心脏排斥证据的患者以及25名正常受试者进行了运动多普勒超声心动图研究。心脏移植患者的基线收缩肺动脉压高于正常受试者，分别为31.6±9 mmHg（均值±标准差）和22.5±4 mmHg（p = 0.0001）。心脏移植患者运动时收缩肺动脉压的升高幅度高出1.4倍，且与移植前肺血管阻力相关（r = 0.55；p = 0.01）。相比之下，两组的基线或运动时心脏指数并无差异。基线或运动时的舒张参数及射血分数与收缩肺动脉压无相关性。总之，多普勒运动超声心动图为移植心脏的血流动力学研究提供了一种安全的替代方法。尽管运动时左心室充盈压异常升高已有充分记录，但仍需进一步研究以调查和描述移植心脏肺血管张力的潜在异常情况。
