Ebeid M R, Ferrer P L, Robinson B, Weatherby N, Gebland H
Department of Pediatrics, University of Miami, School of Medicine, USA.
J Am Soc Echocardiogr. 1996 Nov-Dec;9(6):822-31. doi: 10.1016/s0894-7317(96)90474-5.
Noninvasive assessment of pulmonary vascular resistance has not been well defined. Cardiac catheterization findings in 33 patients with congenital heart disease (mean age 1.4 years) were compared with Doppler echocardiographic parameters. The right ventricular pre-ejection period (RVPEP), ejection time (RVET), and the ration RVPEP/RVET correlated better with pulmonary vascular resistance than with pulmonary artery pressure. A highly significant correlation with a small standard error of estimate (SEE) was demonstrated between pulmonary vascular resistance and a newly derived parameter RVPEP/velocity time integral (VTI) [r = 0.87, p < 0.0001, SEE = 2]. An RVPEP/VTI value of < 0.4 seconds/meter (M) was able to select patients with pulmonary vascular resistance < 3 Wood Unit.M2, even in the presence of pulmonary artery hypertension caused by increased pulmonary blood flow, with 97% accuracy (100% sensitivity, and 92% specificity). An RVPEP/VTI value of 0.4 to 0.6 seconds/M identified patients with pulmonary vascular resistance between 3 to 7.5 Wood Unit.M2 with 91% accuracy, and a value of > or = 0.6 seconds/ M selected patients with total pulmonary vascular resistance > or = 7.5 Wood Unit.M2 with 94% accuracy.
肺血管阻力的无创评估尚未得到很好的界定。对33例先天性心脏病患者（平均年龄1.4岁）的心脏导管检查结果与多普勒超声心动图参数进行了比较。右心室射血前期（RVPEP）、射血时间（RVET）以及RVPEP/RVET与肺血管阻力的相关性优于与肺动脉压力的相关性。肺血管阻力与新推导的参数RVPEP/速度时间积分（VTI）之间显示出高度显著的相关性，估计标准误差（SEE）较小[r = 0.87，p < 0.0001，SEE = 2]。即使存在因肺血流量增加导致的肺动脉高压，RVPEP/VTI值< 0.4秒/米（M）也能够以97%的准确率（100%的敏感性和92%的特异性）筛选出肺血管阻力< 3伍德单位·平方米的患者。RVPEP/VTI值为0.4至0.6秒/M可识别出肺血管阻力在3至7.5伍德单位·平方米之间的患者，准确率为91%，而≥0.6秒/M的值可筛选出总肺血管阻力≥7.5伍德单位·平方米的患者，准确率为94%。
