Ratio of early transmitral velocity to lateral mitral annular early diastolic velocity has the best correlation with wedge pressure following cardiac surgery
Ratio of early transmitral velocity to lateral mitral annular early diastolic velocity has the best correlation with wedge pressure following cardiac surgery
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DOI：
10.1253/circj.71.1274
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发表时间：
2007-08-01
影响因子：
3.3
通讯作者：
Matsuzaki, Masunori
中科院分区：
文献类型：
--
作者：
Hadano, Yasuyuki;Murata, Kazuya;Matsuzaki, Masunori
背景虽然以前的研究报告，二尖瓣环速度预测平均肺毛细血管楔压（PCWP），这是未知的，是否横向或间隔二尖瓣环速度更忠实地预测PCWP后，心脏surgery.Methods和Results评估心脏手术对PCWP的预测值的影响，通过测量二尖瓣环速度，52例连续接受心脏手术的患者进行了研究。所有患者在手术前后均接受经胸超声心动图和右侧心导管检查。应用脉冲多普勒技术测量二尖瓣口舒张早期峰值血流速度（E），应用脉冲组织多普勒成像技术测量二尖瓣环外侧瓣（莱亚）和间隔瓣（SEa）舒张早期峰值血流速度。计算E与莱亚的比值（E/莱亚）和SEa的比值（E/SEa）。超声心动图检查后立即使用球囊肺动脉导管测量PCWP。手术后，莱亚显著增加（6.4 +/- 2.7 vs 8.6 +/- 3.3 cm/s，p < 0.001），但SEa无变化（6.0 +/- 2.5 vs 5.5 +/- 2.3 cm/s，p=0.09）。手术前后E/莱亚与PCWP均呈良好相关（r=0.79和r=0.69，p < 0.001）。结论E/莱亚与PCWP的相关性最好，在无创性评估PCWP中可能比E/SEa更有价值。
Background Although previous investigators reported that mitral annular velocity predicts mean pulmonary capillary wedge pressure (PCWP), it is unknown whether the lateral or septal mitral annular velocity more faithfully predicts PCWP after cardiac surgery.Methods and Results To assess the effect of cardiac surgery on the predictive values for PCWP by measuring mitral annular velocity, 52 consecutive patients undergoing cardiac surgery were studied. All patients underwent transthoracic echocardiography and right-sided cardiac catheterization both before and after surgery. The peak early diastolic velocity of transmitral flow (E) was measured by pulsed-wave Doppler and the peak early diastolic velocities of the lateral (LEa) and septal (SEa) mitral annulus by pulsed-wave tissue Doppler imaging. The ratios of E to LEa (E/LEa) and SEa (E/SEa) were calculated. Immediately after echocardiography, PCWP was measured using a balloon-tipped pulmonary artery catheter. After surgery, LEa was significantly increased (6.4 +/- 2.7 vs 8.6 +/- 3.3 cm/s, p < 0.001), but SEa was unchanged (6.0 +/- 2.5 vs 5.5 +/- 2.3 cm/s, p=0.09). E/LEa correlated well with PCWP both before and after surgery (r=0.79 and r=0.69, respectively, p < 0.001). Although E/SEa correlated well before surgery (r=0.67, p < 0.001), it correlated only weakly after surgery (r=0.44, p < 0.01).Conclusions E/LEa has the best correlation with PCWP both before and after cardiac surgery and may be more useful than E/SEa in the noninvasive estimation of PCWP.