Cottini E, Giacone G, Cosentino M, Rando G, Vintaloro G, De Roberto S
Istituto di Clinica Medica II, Università degli Studi, Catania.
Minerva Cardioangiol. 1994 Oct;42(10):445-60.
Transesophageal echocardiographic studies have permitted a pulmonary venous flow velocity pattern to be identified which is comparable to that recorder using invasive methods. The pattern consists of 4 stages: an anterograde systolic flow with an early (S1) and late (S2) peak velocity, a diastolic anterograde flow (D) and a retrograde flow liked to atrial contraction (Ar). The aim of this study was to evaluate the pattern of pulmonary venous flow velocity using transesophageal and transthoracic colour Doppler echocardiography in normal subjects in an attempt to: 1) determine normal values derived from the pulmonary venous flow pattern which may contribute to future studies; 2) find correlations between the pattern of pulmonary venous flow and a number of physiological, hemodynamic and echocardiographic parameters which take account of the morphological variations of this flow pattern within a normal range; 3) demonstrate the possibility of being able to carry out study using transthoracic colour Doppler echocardiography. The study was carried out in 38 normal subjects aged between 15 and 76 years old (mean 45 +/- 15) who underwent transthoracic and transesophageal colour-Doppler echocardiography. The following parameters were measured: left atrium diameter, diameters and telediastolic and telesystolic volumes of the left ventricle, ejection fraction and systolic percentage shortening of the left ventricle, peak velocity of the mitral flow pattern and the pulmonary venous flow pattern. The results obtained show that: 1) the pattern of pulmonary venous flow alters with ageing causing the prevalence of systolic over diastolic peak velocity; 2) the pulmonary venous flow parameters which appear to be most significant in hemodynamic terms are the peak velocities of the early systolic flow and anterograde diastolic flow and the ratios S1/S2 and S2/D; 3) the echocardiographic parameters most closely correlated with the peak velocity of pulmonary venous flow are the dimensions of the left atrium, telediastolic and telesystolic ventricular volumes, and the pattern of transmitral flow; 4) heart rate does not appear to influence the pulmonary venous flow pattern significantly (at least within the range of 50-100 b/min), except for retrograde flow. Similar results were obtained using transesophageal and transthoracic Doppler echocardiography and therefore if future studies succeed in obtaining useful information, of not only speculative but also practical interest, from the evaluation of pulmonary venous flow, these can be obtained using a simple, widespread and completely non-invasive method such as transthoracic Doppler echocardiography.
经食管超声心动图研究已能够识别出一种肺静脉血流速度模式，该模式与采用侵入性方法记录的模式相似。这种模式包括4个阶段：具有早期（S1）和晚期（S2）峰值速度的收缩期前向血流、舒张期前向血流（D）以及与心房收缩相关的逆向血流（Ar）。本研究的目的是使用经食管和经胸彩色多普勒超声心动图评估正常受试者的肺静脉血流速度模式，以试图：1）确定源自肺静脉血流模式的正常数值，这可能有助于未来的研究；2）找出肺静脉血流模式与一些生理、血流动力学和超声心动图参数之间的相关性，这些参数考虑了该血流模式在正常范围内的形态变化；3）证明能够使用经胸彩色多普勒超声心动图进行研究。该研究在38名年龄在15至76岁（平均45±15岁）的正常受试者中进行，这些受试者接受了经胸和经食管彩色多普勒超声心动图检查。测量了以下参数：左心房直径、左心室直径、舒张末期和收缩末期容积、射血分数以及左心室收缩期缩短百分比、二尖瓣血流模式和肺静脉血流模式的峰值速度。获得的结果表明：1）肺静脉血流模式随年龄增长而改变，导致收缩期峰值速度高于舒张期峰值速度；2）从血流动力学角度来看，似乎最显著的肺静脉血流参数是收缩期早期血流和舒张期前向血流的峰值速度以及S1/S2和S2/D比值；3）与肺静脉血流峰值速度最密切相关的超声心动图参数是左心房尺寸、舒张末期和收缩末期心室容积以及二尖瓣血流模式；4）心率似乎对肺静脉血流模式没有显著影响（至少在50 - 100次/分钟范围内），逆向血流除外。使用经食管和经胸多普勒超声心动图获得了相似的结果，因此，如果未来的研究能够从肺静脉血流评估中成功获得不仅具有推测性而且具有实际意义的有用信息，那么这些信息可以使用一种简单、广泛且完全无创的方法，如经胸多普勒超声心动图来获得。
