Weihs W, Picha R, Schuchlenz H, Harb S, Anelli-Monti B, Harnoncourt K
2. Medizinische Abteilung, Universität Graz.
Dtsch Med Wochenschr. 1994 Aug 5;119(31-32):1061-4. doi: 10.1055/s-2008-1058802.
Doppler-echocardiography (DEC) was performed before cardiac catheterization in 61 consecutive patients (25 women, 36 men; aged 59 +/- 10.6 years) with pulmonary hypertension. Chronic obstructive lung disease was its cause in 32, mitral valve disease in 16 and dilated cardiomyopathy in 13 patients. The subcostal approach was possible in all patients and a semiquantitative assessment into three degrees of severity determined from right ventricular wall thickness and size, as well as the diameter of the inferior vena cava. The severity grade was closely correlated with the level of pulmonary hypertension. In the absence of all signs of increased right ventricular load (grade 0) the mean pulmonary arterial pressure was 18.7 +/- 6.2 mm Hg, in grade I it was 15 and 22 mm Hg (only two patients), in grade II 29.9 +/- 11.9 and in grade III 41.1 +/- 8.6 mm Hg. 13 of the 21 patients in grade 0 or I had no manifest signs of pulmonary hypertension, but this was the case in only 6 of 22 in grade II and none in grade III. In 42 patients (69%) the systolic pulmonary artery pressure could be measured by DEC and it correlated well with the values obtained by cardiac catheterization (P < 0.001, r = 0.92). These findings show that DEC can provide semiquantitative and, in most cases, even exact evidence of chronic right ventricular overload.
对61例连续的肺动脉高压患者（25例女性，36例男性；年龄59±10.6岁）在进行心导管检查前进行了多普勒超声心动图（DEC）检查。其中32例病因是慢性阻塞性肺疾病，16例是二尖瓣疾病，13例是扩张型心肌病。所有患者均可行肋下途径，并根据右心室壁厚度和大小以及下腔静脉直径进行半定量评估，分为三个严重程度等级。严重程度等级与肺动脉高压水平密切相关。在无右心室负荷增加的所有迹象（0级）时，平均肺动脉压为18.7±6.2mmHg，I级时为15和22mmHg（仅2例患者），II级时为29.9±11.9mmHg，III级时为41.1±8.6mmHg。0级或I级的21例患者中有13例无肺动脉高压的明显迹象，但II级的22例中只有6例如此，III级中无1例。42例患者（69%）的收缩期肺动脉压可通过DEC测量，且与心导管检查获得的值相关性良好（P<0.001，r=0.92）。这些发现表明，DEC可以提供慢性右心室负荷过重的半定量证据，并且在大多数情况下甚至可以提供确切证据。
