Doppler echocardiographic prediction of pulmonary arterial hypertension in congenital heart disease.

Doppler echocardiographic prediction of pulmonary arterial hypertension in congenital heart disease.
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先天性心脏病肺动脉高压的多普勒超声心动图预测。

DOI:
10.1016/0002-9149(84)90646-5
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发表时间:
1984
期刊:
The American journal of cardiology
影响因子:
--
通讯作者:
C. Loeber
C. Loeber
中科院分区:
--
文献类型:
--
作者:
D. Kosturakis;Stanley J. Goldberg;Hugh D. Allen;C. Loeber

文献摘要

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This study determines the accuracy of Doppler echocardiography (echo) for predicting the presence of pulmonary artery (PA) hypertension from Doppler PA velocity traces. The patient group included 17 patients with congenital cardiac disease who had undergone catheterization. The control group was composed of 15 normal subjects. Doppler traces were analyzed qualitatively and quantitatively. Qualitative assessment included evaluation for a negative presystolic velocity that was the equivalent of the pulmonary a wave detected by M-mode echo. Quantitative assessment included measurement of the following time intervals and ratio of intervals: preejection period (PEP), time to peak velocity (TPV), right ventricular ejection time (RVET), PEP/RVET and TPV/RVET ratios. In the patient group, systolic PA pressure ranged from 22 to 90 mm Hg (mean 50 ± 23), and mean PA pressure ranged from 12 to 60 mm Hg (mean 32 ± 17). Five patients had systolic PA pressures of ≤30 mm Hg and 12 had systolic PA pressures ≥30 mm Hg. Of 15 control subjects, 14 had a negative presystolic a wave. Of 5 patients with PA pressure ≤30 mm Hg, 4 had a presystolic negative velocity, and all with higher pressures had no presystolic negative velocity. One patient with pressure <30 mm Hg and 2 with PA pressure ∗>30 mm Hg had indeterminate status of presystolic velocity pattern because of turbulence or baseline blanking.The best quantitative indexes for separating patients with normal PA pressure from those with elevated PA pressure were TPV and TPV/RVET, which respectively correlated negatively with systolic PA pressure (r = − 0.82, Standard error of the estimate [SEE] = 0.02;andr = − 0.70, SEE = 0.05). These measurements also correlated negatively with mean PA pressure (r = − 0.75, SEE = 0.02; and r = − 0.76, SEE = 0.05). Other intervals and ratios had enough individual variability to make them less useful as predictors of PA hypertension.