Brunazzi M C, Chirillo F, Pasqualini M, Gemelli M, Franceschini-Grisolia E, Longhini C, Giommi L, Barbaresi F, Stritoni P
Department of Cardiology, Civic Hospital, Legnago, Italy.
Am Heart J. 1994 Aug;128(2):293-300. doi: 10.1016/0002-8703(94)90482-0.
Because analysis of pulmonary venous flow (PVF) will be extensively used in comprehensive Doppler assessment of left ventricular diastolic function, this study was designed to (1) evaluate the feasibility of PVF measurement in 116 consecutive patients with various cardiac abnormalities by using precordial pulsed Doppler echocardiography; (2) Estimate mean pulmonary capillary pressure (MPCP) and left ventricular end-diastolic pressure (LVEDP) from Doppler variables of PVF and mitral inflow; and (3) evaluate the influence of clinical and hemodynamic variables on PVF Doppler patterns. We adequately recorded anterograde PVF in 96 (82.7%) patients and retrograde PVF in 45 (38.7%) patients. The strongest correlation between MPCP and Doppler variables of PVF was found with systolic fraction (the systolic velocity time integral expressed as a fraction of total anterograde PVF) (r = -0.88; p < 0.001). Age influenced this relation, with progressive increase of the systolic fraction in older patients. A good correlation (r = 0.72; p < 0.001) was found between LVEDP and the difference in duration of the reversal PVF and the mitral a wave. In conclusion, (1) PVF can be recorded adequately in most patients with precordial Doppler echocardiography; (2) left ventricular diastolic pressures can be estimated reliably by precordial Doppler echocardiography; and (3) the clinical meaning of Doppler-derived indexes of left ventricular diastolic performance is age-related.
由于肺静脉血流（PVF）分析将广泛应用于左心室舒张功能的综合多普勒评估，本研究旨在：（1）通过心前区脉冲多普勒超声心动图评估116例连续患有各种心脏异常的患者中PVF测量的可行性；（2）根据PVF和二尖瓣血流的多普勒变量估计平均肺毛细血管压（MPCP）和左心室舒张末期压力（LVEDP）；（3）评估临床和血流动力学变量对PVF多普勒模式的影响。我们成功记录了96例（82.7%）患者的顺行PVF和45例（38.7%）患者的逆行PVF。MPCP与PVF多普勒变量之间的最强相关性发现于收缩期分数（收缩期速度时间积分表示为总顺行PVF的分数）（r = -0.88；p < 0.001）。年龄影响这种关系，老年患者的收缩期分数逐渐增加。LVEDP与逆行PVF持续时间和二尖瓣a波持续时间之差之间存在良好的相关性（r = 0.72；p < 0.001）。总之，（1）大多数患者通过心前区多普勒超声心动图可以充分记录PVF；（2）心前区多普勒超声心动图可以可靠地估计左心室舒张压力；（3）左心室舒张功能多普勒衍生指标的临床意义与年龄相关。
