Tanabe K, Yoshitomi H, Oyake N, Asanuma T, Ohta T, Ishibashi Y, Shimada T, Morioka S, Moriyama K
Fourth Department of Internal Medicine, Shimane Medical University, Izumo, Japan.
J Am Coll Cardiol. 1994 Nov 15;24(6):1552-7. doi: 10.1016/0735-1097(94)90154-6.
This study attempted to evaluate the effects of supine and lateral recumbent positions on pulmonary venous flow by transesophageal Doppler echocardiography in healthy subjects.
Although transesophageal echocardiographic examination is usually performed with the patient lying in the left lateral decubitus or supine position, little attention has been paid to the effects of these positions on pulmonary venous flow.
We performed pulsed Doppler transesophageal echocardiography of the left and right pulmonary veins in 16 normal subjects as they lay in the left and right lateral decubitus and supine positions.
Data are reported as mean value +/- SD. Adequate recordings were obtained in 12 subjects (75%). In the left pulmonary vein, peak systolic velocity and time-velocity integral of systolic flow increased significantly in the left compared with the right lateral decubitus position (56 +/- 12 vs. 44 +/- 13 cm/s, p < 0.05, and 15 +/- 4 vs. 9 +/- 4 cm, p < 0.05, respectively). In the right pulmonary vein, peak systolic velocity and time-velocity integral of systolic flow decreased significantly in the left compared with the right lateral decubitus position (38 +/- 10 vs. 48 +/- 9 cm/s, p < 0.05, and 9 +/- 2 vs. 12 +/- 2 cm, p < 0.05, respectively). There were no significant differences between positions in peak diastolic flow velocity, time-velocity integral of diastolic flow or peak velocity of flow reversal at atrial contraction.
Pulmonary venous systolic peak velocities and time-velocity integrals of systolic flow increase when the pulmonary venous recording is from the recumbent subject's lower side. Therefore, the effects of position should be considered in evaluating left ventricular diastolic function by transesophageal Doppler echocardiography.
本研究试图通过经食管多普勒超声心动图评估健康受试者仰卧位和侧卧位对肺静脉血流的影响。
尽管经食管超声心动图检查通常在患者左侧卧位或仰卧位时进行，但这些体位对肺静脉血流的影响很少受到关注。
我们对16名正常受试者在左侧卧位、右侧卧位和仰卧位时进行了左右肺静脉的脉冲多普勒经食管超声心动图检查。
数据以平均值±标准差报告。12名受试者（75%）获得了足够的记录。在左肺静脉，与右侧卧位相比，左侧卧位时收缩期峰值速度和收缩期血流时间速度积分显著增加（分别为56±12 vs. 44±13 cm/s，p<0.05，以及15±4 vs. 9±4 cm，p<0.05）。在右肺静脉，与右侧卧位相比，左侧卧位时收缩期峰值速度和收缩期血流时间速度积分显著降低（分别为38±10 vs. 48±9 cm/s，p<0.05，以及9±2 vs. 12±2 cm，p<0.05）。舒张期峰值流速、舒张期血流时间速度积分或心房收缩时血流逆转峰值速度在不同体位之间无显著差异。
当从卧位受试者的下侧记录肺静脉时，肺静脉收缩期峰值速度和收缩期血流时间速度积分增加。因此，在通过经食管多普勒超声心动图评估左心室舒张功能时应考虑体位的影响。
