Neumann A, Soble J S, Anagnos P C, Kagzi M, Parrillo J E
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College, Chicago, Illinois 60612, USA.
J Am Soc Echocardiogr. 1998 Feb;11(2):126-31. doi: 10.1016/s0894-7317(98)70070-7.
We evaluated the accuracy of a new Doppler-based method using the mitral regurgitant velocity at the time of aortic valve opening for the noninvasive estimation of left ventricular end-diastolic pressure. Sixty unselected patients were studied immediately before routine catheterization. Invasive left ventricular end-diastolic pressure was obtained using a fluid-filled pig-tail catheter. Noninvasive estimation of left ventricular pressure at aortic valve opening was taken as systemic diastolic pressure using an automated cuff. Noninvasive left ventricular end-diastolic pressure was calculated as diastolic blood pressure--4 x (mitral regurgitant velocity at aortic opening)2. Those making noninvasive determinations were blinded to catheterization results. An adequate mitral regurgitant Doppler recording was obtained in 24 patients (40%). In patients with a left ventricular end-diastolic pressure greater than 15 mm Hg the yield was 65%. Left ventricular end-diastolic pressures ranged from 4 mm Hg to 30 mm Hg. Bland and Altman analysis revealed no systematic bias and close agreement was found, with individual discrepancies not exceeding 5 mm Hg.
我们评估了一种基于多普勒的新方法的准确性，该方法利用主动脉瓣开放时的二尖瓣反流速度对左心室舒张末期压力进行无创估计。在60例未经挑选的患者进行常规心导管检查前，对其进行了研究。使用充满液体的猪尾导管获取有创左心室舒张末期压力。使用自动袖带将主动脉瓣开放时左心室压力的无创估计值作为体循环舒张压。无创左心室舒张末期压力计算为舒张压 - 4×（主动脉瓣开放时二尖瓣反流速度）²。进行无创测定的人员对导管检查结果不知情。24例患者（40%）获得了足够的二尖瓣反流多普勒记录。在左心室舒张末期压力大于15 mmHg的患者中，成功率为65%。左心室舒张末期压力范围为4 mmHg至30 mmHg。Bland和Altman分析显示无系统偏差，且一致性良好，个体差异不超过5 mmHg。
