Feasibility of obtaining pulmonary venous flow velocity in cardiac patients using transthoracic pulsed wave Doppler technique
Feasibility of obtaining pulmonary venous flow velocity in cardiac patients using transthoracic pulsed wave Doppler technique
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DOI：
10.1016/s0894-7317(97)80033-8
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发表时间：
1997-01-01
影响因子：
6.5
通讯作者：
Appleton, CP
中科院分区：
文献类型：
--
作者：
Jensen, JL;Williams, FE;Appleton, CP
本研究的目的是确定，在成人人群中，使用目前的经胸脉冲波多普勒技术可以获得高质量肺静脉流速记录的患者百分比。用脉冲波多普勒法获得的肺静脉和二尖瓣血流速度变量用于间接评估左室（LV）舒张功能和左室充盈压力。然而，这些方法的一般临床应用仍然不确定，因为获得肺静脉流速所有成分的经胸成功率是可变的，有时报道低至30%至60%。使用脉冲波多普勒信号获得200例连续进行超声心动图研究的正常窦性心律成人患者（平均年龄68.2±11.4岁）的二尖瓣和肺静脉流速变量。使用了6台心脏超声仪和5台超声波系统。获得肺静脉收缩期和舒张期流速的成功率为95%，获得心房收缩期逆流流速的成功率为90%，获得心房收缩期逆流持续时间的成功率为89%。在5% - 11%的肺血流速度不能被充分记录的患者中，最常见的原因是脉冲波多普勒仪深度受限、心脏明显增大或左房壁运动伪影。成功率还受到所使用的超声设备、超声医师之间的个体差异，甚至相关二尖瓣充盈模式的类型（受损、假正常、受限）的影响。鉴于目前的机器技术、超声医师教育和日常实践，使用经胸前多普勒技术可以在大约90%的成年患者中获得高质量、完整的肺静脉流速记录。这些结果表明，使用这些变量作为辅助评估左室舒张功能和充盈压力可能比以前认为的具有更广泛的临床适用性。
The purpose of this study was to determine, in an adult population, the percentage of patients in whom high quality pulmonary venous flow velocity recordings can be obtained using current transthoracic pulsed wave Doppler techniques. Pulmonary venous and mitral flow velocity variables obtained with a pulsed wave Doppler method were used for the indirect assessment of left ventricular (LV) diastolic function and LV filling pressures. The general clinical use of these methods, however, remains uncertain because the transthoracic success rate of obtaining all components of pulmonary venous flow velocity has been variable, and sometimes reported to be as low as 30% to 60%. Mitral and pulmonary venous flow velocity variables were obtained using pulsed wave Doppler signals in 200 consecutive adult patients (mean age 68.2 +/- 11.4 years) in normal sinus rhythm who were referred for echocardiographic study. Six cardiac sonographers and five ultra sound systems were used. The success rate for obtaining pulmonary venous systolic and diastolic how velocity was 95%, reverse flow velocity at atrial contraction was 90%, and the duration of reverse flow at atrial contraction was 89%. In the 5% to 11% of patients in whom pulmonary flow velocities could not be adequately recorded, the most common reasons were depth limitations of the pulsed wave Doppler machine, marked cardiac enlargement, or left atrial wall motion artifact. The success rate also was influenced by the ultrasound equipment used, individual variation among sonographers, and even the type (impaired, pseudonormal, restricted) of associated mitral filling pattern. Given current machine teehnology, sonographer education, and daily practice, high quality, complete recordings of pulmonary venous how velocity can be obtained in approximately 90% of adult patients using the precordial transthoracic Doppler technique. These results suggest that using these variables as an aid for evaluating LV diastolic function and filling pressures may have broader clinical applicability than previously appreciated.