Gentile F, Mantero A, Lippolis A, Ornaghi M, Azzollini M, Barbier P, Beretta L, Casazza F, Corno R, Faletra F, Giagnoni E, Gualtierotti C, Lombroso S, Mattioli R, Morabito A, Pepi M, Todd S, Pezzano A
Department of Cardiology, Bassini Hospital, Milano, Italy.
Eur Heart J. 1997 Jan;18(1):148-64. doi: 10.1093/oxfordjournals.eurheartj.a015097.
In order to find out the normal values and to evaluate the effects of age, heart rate, sex, and haemodynamic and standard echocardiographic parameters on pulmonary venous flow velocity obtained by the transthoracic approach. Doppler pulmonary venous flow parameters were measured in 143 healthy subjects aged from 20 to 80 years. Doppler pulmonary venous flow parameters which had the best correlation with age were: the peak velocity of the systolic wave (r = 0.39) and its integral (r = 0.5), the peak velocity of the diastolic wave (r = -0.6) and its integral (r = -0.44); the systolic (r = 0.68) and diastolic fractions (r = -0.68); the systolic/diastolic peak velocity ratio (r = 0.73) and the systolic/diastolic integral ratio (r = 0.7). The atrial reversal wave did not correlate with age; the atrial reversal wave was more difficult and probably less reliable to measure than the systolic and diastolic waves. The correlations of pulmonary venous flow parameters with mitral flow parameters were also examined. This study showed that, in healthy subjects, despite an increase in the early and atrial waves from the annulus to the tips of the mitral leaflets, there is a similar association between pulmonary venous flow and mitral flow measured at the annulus or at the tips of the mitral leaflets. The intra-observer reproducibility of all the pulmonary venous flow parameters considered were found to be excellent. Moderate inter-observer variability was observed for the systolic, diastolic and atrial reversal wave peak velocities and integrals; however, the systolic/diastolic ratio improved the precision of the measurements. Multivariate analysis showed that age is the principal determinant of the Doppler parameters of pulmonary venous flow: heart rate, sex, body surface area, the size of the left atrium in systole and the left ventricular ejection fraction all influence the Doppler parameters of pulmonary venous flow, even if only slightly.
为了确定正常数值，并评估年龄、心率、性别、血流动力学和标准超声心动图参数对经胸途径获得的肺静脉血流速度的影响。对143名年龄在20至80岁的健康受试者测量了多普勒肺静脉血流参数。与年龄相关性最好的多普勒肺静脉血流参数为：收缩期波峰速度（r = 0.39）及其积分（r = 0.5）、舒张期波峰速度（r = -0.6）及其积分（r = -0.44）；收缩期（r = 0.68）和舒张期分数（r = -0.68）；收缩期/舒张期波峰速度比值（r = 0.73）和收缩期/舒张期积分比值（r = 0.7）。心房逆向波与年龄无相关性；与收缩期和舒张期波相比，心房逆向波测量更困难且可能可靠性更低。还研究了肺静脉血流参数与二尖瓣血流参数的相关性。本研究表明，在健康受试者中，尽管从二尖瓣环到二尖瓣叶尖的早期和心房波有所增加，但在二尖瓣环或二尖瓣叶尖测量的肺静脉血流与二尖瓣血流之间存在相似的关联。所有考虑的肺静脉血流参数的观察者内重复性都非常好。观察到收缩期、舒张期和心房逆向波峰速度及积分存在中等程度的观察者间变异性；然而，收缩期/舒张期比值提高了测量的精度。多变量分析表明，年龄是肺静脉血流多普勒参数的主要决定因素：心率、性别、体表面积、收缩期左心房大小和左心室射血分数均对肺静脉血流多普勒参数有影响，即使影响较小。
