Oki T, Kageji Y, Fukuda N, Iuchi A, Tabata T, Manabe K, Yamada H, Fukuda K, Ito S
Second Department of Internal Medicine, Tokushima University School of Medicine, Japan.
Jpn Heart J. 1996 May;37(3):333-42. doi: 10.1536/ihj.37.333.
To determine whether transmitral and pulmonary venous flow velocity patterns can be used to evaluate left atrial pressure and volume changes during atrial systole, we performed transesophageal pulsed Doppler echocardiography and right heart catheterization in 85 patients (20 with hypertrophic cardiomyopathy, 20 with dilated cardiomyopathy, 30 with prior myocardial infarction, and 15 with mitral regurgitation), and 35 normal subjects. Pulsed Doppler variables from transmitral and pulmonary venous flow velocities during atrial systole were compared with mean pulmonary capillary wedge pressure (mean PCWP), pressure rise during atrial systole (PCWP-A), and left atrial volume change during atrial systole (delta LAV). The mean PCWP correlated significantly with the peak atrial systolic transmitral flow (r = -0.38, p < 0.05) and pulmonary venous flow (r = 0.40, p < 0.05) velocities in all patients. The PCWP-A correlated significantly with the peak atrial systolic transmitral flow (r = -0.39, p < 0.05) and pulmonary venous flow (r = 0.68, p < 0.0001) velocities in all patients. There was a particularly close correlation between the PCWP-A and the peak atrial systolic pulmonary venous flow velocities. The sum of the time-velocity integral of the atrial systolic transmitral and pulmonary venous flow velocities (TAI) correlated closely with the delta LAV (r = 0.70, p < 0.0001) in all patients. Thus, the peak atrial systolic pulmonary venous flow velocity correlated well with left atrial pressure changes during atrial systole. Furthermore, the sum of the time-velocity integral of the atrial systolic transmitral and pulmonary venous flow velocities correlated well with left atrial volume changes during atrial systole. Therefore, transesophageal echocardiographic measurements of atrial systolic transmitral and pulmonary venous flow velocities are reasonable indicators of left atrial pressure and volume changes during atrial systole.
为了确定经二尖瓣和肺静脉血流速度模式是否可用于评估心房收缩期左心房压力和容积变化，我们对85例患者（20例肥厚型心肌病、20例扩张型心肌病、30例既往心肌梗死和15例二尖瓣反流）以及35名正常受试者进行了经食管脉冲多普勒超声心动图检查和右心导管检查。将心房收缩期经二尖瓣和肺静脉血流速度的脉冲多普勒变量与平均肺毛细血管楔压（平均PCWP）、心房收缩期压力升高（PCWP - A）以及心房收缩期左心房容积变化（ΔLAV）进行比较。在所有患者中，平均PCWP与心房收缩期经二尖瓣血流峰值（r = -0.38，p < 0.05）和肺静脉血流（r = 0.40，p < 0.05）速度显著相关。在所有患者中，PCWP - A与心房收缩期经二尖瓣血流峰值（r = -0.39，p < 0.05）和肺静脉血流（r = 0.68，p < 0.0001）速度显著相关。PCWP - A与心房收缩期肺静脉血流峰值速度之间存在特别密切的相关性。在所有患者中，心房收缩期经二尖瓣和肺静脉血流速度的时间 - 速度积分总和（TAI）与ΔLAV密切相关（r = 0.70，p < 0.0001）。因此，心房收缩期肺静脉血流峰值速度与心房收缩期左心房压力变化密切相关。此外，心房收缩期经二尖瓣和肺静脉血流速度的时间 - 速度积分总和与心房收缩期左心房容积变化密切相关。因此，经食管超声心动图测量心房收缩期经二尖瓣和肺静脉血流速度是心房收缩期左心房压力和容积变化的合理指标。
