多普勒超声心动图评估左心室舒张末压的研究

Estimation of Left Ventricular End Diastolic Pressure by Transthoracic Doppler Echocardiography

目的探讨多普勒超声心动图评估左室舒张末压的有效方法与指标。方法对６８例病人采用左心导管测压及经胸多普勒超声心动图检测。结果对比研究显示，联合肺静脉与二尖瓣血流频谱分析优于二尖瓣血流频谱分析，肺静脉Ａ峰和二尖瓣Ａ峰时限差值（ＰＡｄ－Ａｄ）与左室舒张末压实测值呈最佳相关性（ｒ＝０．７２，Ｐ＜０．０１）。结论认为应用多普勒超声心动图测定ＰＡｄ与Ａｄ，并以其差值估测左室舒张末压，是一项简便、可靠的无创性评估左室舒张末压的方法。ＰＡｄ－Ａｄ≥０可作为临床判断左室舒张末压增高［≥２．０ｋＰａ（１５ｍｍＨｇ）］的一项半定量指标。

Objective\ The aim of this study was designed to investigate the useful method and index in estimating left ventricular end diastolic pressure (LVEDP) by Doppler echocardiography. Methods\ Invasive LVEDP was measured in 68 patients undergoing cardiac catheterization. Mitral and pulmonary venous flow velocity variables were recorded by transthoracic pulsed Doppler echocardiography. Results\ The method combined both transmitral and pulmonary venous flow spectra was better than that of transmitral flow spectrum alone. The difference in pulmonary venous and mitral A wave durations showed the best correlation with the LVEDP ( r=0.72, P <0.01). Conclusion\ This result indicated that Doppler echocardiography is convenient, reliable and noninvasive for assessing LVEDP. PAd Ad≥0 may provide a semiquantitative index for prediction of elevated LVEDP (≥2.0 kPa, 15 mmHg).