Diagnostic value of echo-Doppler and tissue Doppler imaging in dogs with pulmonary arterial hypertension.
Diagnostic value of echo-Doppler and tissue Doppler imaging in dogs with pulmonary arterial hypertension.
复制标题
超声多普勒和组织多普勒成像对犬肺动脉高压的诊断价值。
DOI：
10.1111/j.1939-1676.2007.tb01950.x
复制
发表时间：
2007
影响因子：
2.6
通讯作者：
J. Pouchelon
中科院分区：
文献类型：
--
作者：
F. Serres;V. Chetboul;V. Gouni;R. Tissier;C. C. Sampedrano;J. Pouchelon
背景
肺动脉高压（PAH）的诊断依赖于肺动脉和三尖瓣返流（TR）的多普勒测量。然而，这些并不总是可检测的。
假设
组织多普勒成像（TDI）是一种新的无创超声技术，可间接但敏感和特异地评估犬肺动脉收缩压（SPAP）升高。
动物
105只狗患有TR。
方法
前瞻性观察性研究。根据TR峰值速度（分别为< 2.5、2.5-3.0和> 3.0 m/s），将犬分为SPAP正常（第1组，n = 45）、轻度增加（第2组，n = 19）或中度至重度增加（第3组，n = 41）。评估了10个定量超声多普勒和TDI衍生变量，包括主肺动脉直径与主动脉直径比、肺血流加速时间和加速射血时间比、右心室功能Tei指数和6个纵向基础右心室TDI变量。
结果
SPAP与10个测试变量中的每一个都有显著相关性（P <0.05）。常规超声多普勒变量在预测SPAP增加方面的鉴别力低于TDI。合并的收缩期和舒张期右TDI指数具有最高的灵敏度和特异性（分别为89%和93%，截止值为11.8 cm/s），并且可以区分第1组和第2组中的犬。
结论和临床重要性
TDI提供了收缩期PAH的有效预测因子，并证明右侧收缩期和舒张期心肌功能的改变均可伴随SPAP轻度升高。
BACKGROUND
Diagnosis of pulmonary arterial hypertension (PAH) relies on Doppler measurement of pulmonic and tricuspid regurgitation (TR). However, these are not always detectable.
HYPOTHESIS
Tissue Doppler imaging (TDI), a novel noninvasive ultrasound technique, provides indirect but sensitive and specific assessment of elevated systolic pulmonary artery pressure (SPAP) in dogs.
ANIMALS
One hundred and five dogs with TR.
METHODS
Prospective observational study. Dogs were categorized as presenting normal (group 1, n = 45), mildly increased (group 2, n = 19), or moderately to severely increased (group 3, n = 41) SPAP, based on TR peak velocities (< 2.5, 2.5-3.0, and > 3.0 m/s, respectively). Ten quantitative echo-Doppler- and TDI-derived variables were assessed, including the main pulmonary arterial diameter to aortic diameter ratio, pulmonary flow acceleration time, and acceleration-to-ejection time ratio, the Tei index of right ventricular function, and 6 longitudinal basal right ventricular TDI variables.
RESULTS
A significant correlation was observed between SPAP and each of the 10 tested variables (P < .05). Conventional echo-Doppler variables were less discriminating than the TDI for predicting increased SPAP. The combined systolic and diastolic right TDI index had the highest sensitivity and specificity (89% and 93% respectively, for a cutoff of 11.8 cm/s) and could discriminate between dogs in group 1 from dogs in group 2.
CONCLUSIONS AND CLINICAL IMPORTANCE
TDI provided effective predictors of systolic PAH and demonstrated that both alterations in right-sided systolic and diastolic myocardial function can occur with mild increases in SPAP.