超声心动图评估肺高压患者肺毛细血管楔压

摘要

Objective To explore the association between Doppler echocardiography parameters and pulmonary capillary wedge pressure (PCWP) obtained by right heart catheterization (RHC) in patients with pulmonary hypertension (PH).Methods RHC and a simultaneous echocardiography were performed in 86 PH patients.The correlation between the echocardiographic parameters and PCWP was analyzed.Results The early diastolic velocity(E) of mitral valve blood flow was significantly correlated with PCWP ( γ =0.36,P ＜0.01 ).Tissue Doppler imaging measured the diastolic velocity of mitral annulus on the lateral(E'L)and the septal (E'S) wall.Then the average E'M was calculated.The ratio of E to E'L,E'S and E'M showed a strong correlation with PCWP ( γ =0.62,0.34 and 0.47 respectively,P ＜ 0.01 ).E/E'L ＜ 6 accurately predicted 100％ PCWP≤ 15 mm Hg (1 mm Hg =0.133 kPa),and E/E'L ＞ 15 could predict PCWP ＞ 15 nun Hg with specificity of 98.5％.Conclusion There are positive correlation between E/E' and PCWP obtained by RHC in PH patients.%目的 探讨肺高压患者中超声心动图参数与右心导管(RHC)测定肺毛细血管楔压(PCWP)之间的关系.方法 对86例肺高压患者同时进行RHC和超声心动图检查,将多普勒指标与PCWP进行相关性分析.结果 二尖瓣跨瓣血流速度舒张早期峰值(E)与PCWP有显著相关(γ=0.36,P＜0.01).组织多普勒测定二尖瓣环侧壁(L)和间隔(S)的运动速度舒张早期峰值(分别为E'L、E'S),并计算二者的平均值(E'M)；二尖瓣E分别与E'L、E'S和E'M的比值(即E/E'L、E/E'S和E/E'M)均与PCWP有显著相关性(r分别为0.62、0.34和0.47,P＜0.01),由二尖瓣环侧壁获取的E/E'L ＜6能够100％地预测PCWP≤15 mm Hg(1 mm Hg=0.133 kPa),E/E'L＞ 15预测PCWP＞15 mm Hg的特异性为98.5％.结论 在肺高压患者中,超声心动图获取的二尖瓣E峰和二尖瓣环运动速度(E ')比值E/E’与RHC测量的PCWP有良好的相关性.