Comparison of Doppler echocardiography and right heart catheterization to assess pulmonary hypertension in systemic sclerosis.
Comparison of Doppler echocardiography and right heart catheterization to assess pulmonary hypertension in systemic sclerosis.
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多普勒超声心动图和右心导管插入术评估系统性硬化症肺动脉高压的比较。
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发表时间：
1997
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通讯作者：
R. Bois
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作者：
C. Denton;J. Cailes;G. D. Phillips;A. Wells;C. Black;R. Bois
肺动脉高压（PHT）是系统性硬化症（SSc）的重要并发症。超声心动图可用于检测PHT，多普勒超声心动图通常可估计肺动脉收缩压（PASP）。我们对33例临床评估[包括ECG、胸部X线、肺功能检查和高分辨率计算机断层扫描（HRCT）]强烈怀疑PHT的SSc患者进行了一项研究，以比较超声心动图评估与右心导管检查（RHC）。平均值（S.D.）超声心动图和RHC之间的间隔为1.8（2.3）个月。21例患者（64%）在RHC上有PHT（PASP ≥ 30 mmHg），超声心动图正确识别了其中19例（敏感性90%）。在12例RHC无PHT的患者中，9例被超声心动图正确识别（特异性75%）。5例分类错误的患者的PASP均在正常/异常的边界范围内。三尖瓣返流允许多普勒测量20例患者（61%）的PASP，这与RHC值显著相关（r = 0.83，P < 0.001）。我们的结论是，超声心动图是一种可靠的方法检测PHT，它可能是特别有用的早期检测和监测这种潜在的致命并发症在SSc。
Pulmonary hypertension (PHT) is an important complication of systemic sclerosis (SSc). Echocardiography can be used to detect PHT and, with Doppler echocardiography, the pulmonary arterial systolic pressure (PASP) can often be estimated. We have undertaken a study to compare echocardiographic assessment with right heart catheterization (RHC) in 33 SSc patients in whom clinical assessment [including ECG, chest X-ray, lung function tests and high-resolution computed tomography (HRCT) had raised strong suspicion of PHT. The mean (S.D.) interval between echocardiography and RHC was 1.8 (2.3) months. Twenty-one patients (64%) had PHT (PASP > or = 30 mmHg) on RHC, and echocardiography correctly identified 19 of these (sensitivity 90%). Of the 12 patients without PHT on RHC, nine were correctly identified by echocardiography (specificity 75%). The five incorrectly classified patients all had PASP in the borderline normal/abnormal range. The presence of tricuspid regurgitation allowed Doppler measurement of PASP in 20 patients (61%) and this correlated significantly with RHC values (r = 0.83, P < 0.001). We conclude that echocardiography is a reliable method for detecting PHT and it may be particularly useful for the early detection and monitoring of this potentially fatal complication in SSc.