呼吸对右心衰竭患者三尖瓣反流速度和肺动脉压测定的影响

Effects of respiration on the velocity of tricuspid regurgitation and estimation of pulmonary artery systolic pressure in patients with right ventricle dysfunction

目的探讨平静呼吸对右心衰竭患者三尖瓣反流速度和肺动脉收缩压测定的影响。方法选取32例右心衰竭患者(病例组)和28例右心功能正常而三尖瓣反流患者(对照组)行超声心动图检查。观测三尖瓣反流速度,根据反流法计算肺动脉收缩压,比较两组吸气相与呼气相之间的差异。结果病例组三尖瓣反流速度、肺动脉收缩压吸气相均小于呼气相(P<0.001);对照组三尖瓣反流速度、肺动脉收缩压吸气相与呼气相比较差异无统计学意义。结论使用超声心动图估测肺动脉收缩压时,应注意平静呼吸对右心衰竭患者三尖瓣反流速度和肺动脉收缩压测定的影响,尽量在呼气末或呼气末屏气状态下进行。

Objective To investigate the effects of quiet respiration on the velocity of tricuspid regurgitation (TR) and estimation of pulmonary artery systolic pressure ( PASP ) in patients with right ventricular dysfunction by echocardiography . Methods Thirty-two patients with right ventricular dysfunction and twenty-eight controls with normal right ventricular function were enrolled. Continuous-wave Doppler spectra of TR were recorded, and electrocardiogram and respiratory tracing were recorded simultaneously. The velocity of TR and PASP were measured during different respiration phases for analyzing. Results For 32 patients with right ventricular dysfunction, both the velocity of TR and PASP in inspiration phase were smaller than those in expiration phase(P<0.001). For 28 controls with normal right ventricular function, there was no significant difference in the volocity between inspiration phase and expiration phase. Conclusion Quiet respiration will affect the velocity of TR and PASP in patients with right ventricle dysfunction. The determination with Doppler echocardiography should be performed at the time that patients hold their breath at the end of expiration.