Richards D R, Gilliland Y, Bernal J A, Smart F W, Stapleton D D, Ventura H O, Cheirif J
Department of Internal Medicine, Ochsner Medical Institutions, New Orleans, LA, USA.
Am Heart J. 1998 Apr;135(4):641-6. doi: 10.1016/s0002-8703(98)70280-7.
Noninvasive estimation of pulmonary capillary wedge pressure (PCWP) with Doppler-derived mitral inflow pattern has been shown to correlate well with invasively measured PCWP; however, it has not yet been determined whether Doppler-derived mitral inflow pattern can be used to estimate PCWP accurately in heart transplant recipients.
To determine if mitral and pulmonary venous inflow data can be applied to calculate PCWP in heart transplant recipients, some-day echocardiograms and right heart catheterizations were reviewed and 83 echocardiograms with adequate mitral inflow patterns in 53 patients were studied. Twenty-eight studies that also had adequate pulmonary venous inflow patterns were selected for offline analysis.
Using a previously published formula [PCWP = 17 + (5.3 x E/A) - (0.11 x IVRT)], where E/A is the ratio of early to late mitral inflow velocities and IVRT is the isovolumic relaxation time, we derived a calculated PCWP, the results of which compared poorly with the measured PCWP (r = 0.33; p = 0.002). Linear regression analysis of measured PCWP versus mitral inflow Doppler flow velocity parameters also revealed poor to modest correlation. Adding parameters derived from the pulmonary venous inflow patterns failed to improve this correlation.
Doppler-derived estimation of PCWP with mitral and pulmonary venous inflow patterns cannot be used to reliably predict PCWP in heart transplant recipients.
已证明利用多普勒衍生的二尖瓣血流模式对肺毛细血管楔压（PCWP）进行无创估计与有创测量的PCWP具有良好的相关性；然而，尚未确定多普勒衍生的二尖瓣血流模式是否可用于准确估计心脏移植受者的PCWP。
为了确定二尖瓣和肺静脉血流数据是否可用于计算心脏移植受者的PCWP，回顾了某天的超声心动图和右心导管检查，并研究了53例患者中83份具有足够二尖瓣血流模式的超声心动图。选择了28份同时具有足够肺静脉血流模式的研究进行离线分析。
使用先前发表的公式[PCWP = 17 +（5.3×E/A）-（0.11×IVRT）]，其中E/A是二尖瓣早期与晚期血流速度之比，IVRT是等容舒张时间，我们得出了计算的PCWP，其结果与测量的PCWP相比差异较大（r = 0.33；p = 0.002）。测量的PCWP与二尖瓣血流多普勒流速参数的线性回归分析也显示相关性较差至中等。添加从肺静脉血流模式得出的参数未能改善这种相关性。
利用二尖瓣和肺静脉血流模式通过多普勒估计PCWP不能可靠地预测心脏移植受者的PCWP。
