Portable spectral Doppler echocardiographic device: overcoming limitations
Portable spectral Doppler echocardiographic device: overcoming limitations
复制标题
便携式频谱多普勒超声心动图设备：克服局限性
作者：
Bryan Williams
背景资料：有证据表明，新的便携式超声心动图设备是有用的，在评估心脏解剖结构和功能，但缺乏多普勒模式，到目前为止，在获得血液动力学数据的一个重要限制。目的：报告一种新的手持式超声心动图设备的多普勒功能。设计：两种超声心动图机的盲法比较。设置：三级护理中心。患者：98名连续患者随机使用手持设备进行成像，标准平台作为参考。结局指标：记录脉冲波经二尖瓣多普勒流入道速度、减速时间和连续波多普勒测量主动脉瓣射血和三尖瓣返流峰值速度。结果如下：手持式装置和标准超声心动图在评价舒张期E和A波、E/A比值和脉冲波多普勒减速时间方面具有极好的一致性（组内相关系数分别为0.97、0.93、0.90和0.78）。此外，连续波多普勒测量主动脉射血和三尖瓣返流速度之间存在良好的一致性（组内相关系数分别为0.96和0.80）。然而，用手持装置（25.5%）和标准超声心动图（65.3%）测量的三尖瓣返流患者之间存在显著差异，导致8例明显肺动脉高压患者被误诊。结论：具有多普勒功能的新型手持设备克服了以前在评价血液动力学变量方面的局限性。彩色多普勒超声可用于全面评价瓣膜病和舒张功能。然而，在肺动脉压的评估中仍然存在重要的局限性。
Background: There is evidence that new portable echocardiographic devices are useful in evaluating heart anatomy and function, but a lack of Doppler modes has up to now been an important limitation in obtaining haemodynamic data. Objectives: To report the Doppler capabilities of a new hand held echocardiographic device. Design: Blinded comparison of two types of echocardiography machine. Setting: Tertiary care centre. Patients: 98 consecutive patients were randomly imaged with the hand held device, with a standard platform as reference. Outcome measures: Pulsed wave transmitral Doppler inflow tract velocities, deceleration time, and continuous wave Doppler measurements of aortic ejection and tricuspid regurgitation peak velocities were recorded. Results: There was excellent agreement between the hand held device and standard echocardiography for the evaluation of diastolic E and A waves, E/A ratio, and deceleration time with pulsed wave Doppler (intraclass correlation coefficients of 0.97, 0.93, 0.90, and 0.78, respectively). In addition, good agreement was found between continuous wave Doppler measurements of aortic ejection and tricuspid regurgitation velocities (intraclass correlation coefficients of 0.96 and 0.80). However, there was a significant difference between patients with tricuspid regurgitation measured with the hand held device (25.5%) and by standard echocardiography (65.3%), resulting in misdiagnosis of eight patients with pronounced pulmonary hypertension. Conclusions: New hand held devices with Doppler capabilities overcome previous limitations in evaluating haemodynamic variables. With colour Doppler they are now suitable for the complete evaluation of valvar disease and diastolic function. However, important limitations remain in the evaluation of pulmonary pressures.