二维超声心动图估测右室收缩压

NONINVASIVE ASSESSMENT OF RIGHT VENTRICULAR SYSTOLIC PRESSURE: A TWO-DIMENSIONAL ECHOCARDIOGRAPHIC STUDY

对38例先天性心脏病(CHD)病人用右心导管法测得右室收缩压(RVSP),并用二维超声心动图(2DE)测定左室偏心指数(eccentricity index,EI),研究RVSP与EI的关系,探讨用EI估测RVSP的可行性及其价值。材料与方法CHD病人38例,其中男14例,女24例。年龄3～27岁(平均11岁)。无心律失常,心(?),血压正常。

To determine if 2-dimensional echocardiography can be used to predict right ventricular systolic pressure(RVSP) in patients with congenital heart disease(CHD), the left ventricular eccentricity index (EI) in short axis 2-dimensional echocardiogram were measured in 12 normal children (Group 1) and 38 patients with CHD. According to the degree of elevation of RVSP measured at cardiac catheterization, the patients were grouped as follows: Group 2, RVSP≤3.99kPa (30mmHg), n=10; Group3, RVSP～6.65kPa (50mmHg), n=10; Group 4, RVSP～9.31kPa (70mmHg), n=8; and Croup 5, RVSP>9.31kPa, n=10. The changes of end-systolic and end-diastolic EI (EIs and EId), and their relation to RVSP in all groups were analysed. The results showed that(1) EIs and Eld correlated well with RVSP(r=0.84 and 0.73 respectively), regression equation: RVSP (kPa)=7.94EIs-2.83; RVSP=6.70EId-1.21; (2) EIs showed no statistical difference between Group 1 and 2; (3) In Group 2 to 5, El was statistically different between any two groups (P<0.05 or 0.01); (4)EId was statistically different only between certain groups, but not so in others; (5) The sensitivity and specificity of EIs for the evaluation of RVSP are 67% and 88%. These data indicate that Els measured in 2-dimensional echocardiogram increase with elevated RVSP. It is normal in patients without elevated RVSP, but significantly increased in those with elevated RVSP. EI is useful for semiquantitative assessment of RVSP. in patients with CHD. The method has proved to be simple, noninvasive, and can be repeated. It is valuable and useful for the clinical detection of elevated RVSP.