Noninvasive assessment of pulmonary vascular resistance using Doppler tissue imaging of the tricuspid annulus
Noninvasive assessment of pulmonary vascular resistance using Doppler tissue imaging of the tricuspid annulus
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DOI：
10.1016/j.echo.2007.02.004
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发表时间：
2007-10-01
影响因子：
6.5
通讯作者：
Blanchard, Daniel G.
中科院分区：
文献类型：
--
作者：
Gurudevan, Swaminatha V.;Malouf, Philip J.;Blanchard, Daniel G.
背景：肺动脉压(PAP)和肺血管阻力(PVR)是晚期心肺疾病患者重要的血流动力学参数。我们开展了这项研究，以确定三尖瓣环的多普勒组织成像是否可以无创性地评估PAP和PVR。方法：我们研究了连续50例可疑的慢性血栓栓塞性肺动脉高压患者。我们在手术前进行了经胸超声心动图和三尖瓣环的多普勒组织成像。结果：三尖瓣环的收缩速度(ts(M))与心导管测得的平均PAP呈负相关，相关系数为-0.493(P=.0003)。TS(M)与插管后的PVR呈负相关，相关系数为-0.710(P<；0.0001)。在此基础上，建立了Pvr=3698-1227xln(ts(M))的对数回归方程。侧方三尖瓣环的多普勒组织成像是一种有用的临床工具，可以为慢性血栓栓塞性肺动脉高压患者的PVR提供无创性的评估。在这个人群中，ts(M)值的下降预示着PVR的测量值逐渐增加。
Background: Pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) are important hemodynamic parameters in patients with advanced cardiopulmonary disease. We undertook this study to determine whether Doppler tissue imaging of the tricuspid annulus could be used to assess PAP and PVR noninvasively.Methods: We studied 50 consecutive patients with suspected chronic thromboembolic pulmonary hypertension referred to our center for evaluation. We performed preoperative transthoracic echocardiography with Doppler tissue imaging of the tricuspid annulus. All patients then underwent cardiac catheterization with invasive determination of cardiac output, PAP, and PVR.Results: The systolic velocity of the tricuspid annulus (tS(m)) had an inverse relationship with catheterization-derived mean PAP, with a correlation coefficient of -0.493 (P = .0003). The inverse correlation of tS(m) with catheterization-derived PVR was more striking, with a correlation coefficient of -0.710 (P < .0001). Based on the data, we derived the following logarithmic regression equation: PVR = 3698-1227 x ln(tS(m)).Conclusions. Doppler tissue imaging of the lateral tricuspid annulus is a useful clinical tool that can provide a noninvasive estimate of PVR in patients with chronic thromboembolic pulmonary hypertension. in this population, decreasing values of tS(m) predicted progressively higher measurements of PVR.