经胸多普勒超声心动图半定量评估左室舒张末压

目的 :探讨经胸多普勒超声心动图半定量评估左室舒张末压 （L VEDP,EDP）的有效指标。方法 :对 88例患者由左心导管介入性检测 L VEDP,经胸多普勒超声心动图记录二尖瓣及肺静脉血流参数。以 EDP实测值作为金标准 ,进行无创与有创性检测的对比研究。结果 :直线相关分析显示 ,肺静脉 A波与二尖瓣 A波时限差值 （PAd- Ad）与 EDP相关最佳 （r=0 .73,P<0 .0 1） ;肺静脉 A波时限等于或超过二尖瓣 A波时限 （即 PAd- Ad≥ 0 ）估测 EDP≥15 m m Hg（1mm Hg=0 .133k Pa）的敏感性为 85 .1% ,特异性为 90 .2 % ,阳性预测值为 90 .9% ,阴性预测值为84.1%。结论 :由多普勒超声心动图血流参数 PAd- Ad≥ 0可作为临床判断 L VEDP≥ 15 mm Hg的一项简便而可靠的半定量指标。

Semi-quantitative assessment of left ventricular end-diastolic pressure with t ransthoracic ultrasound

AIM:This study was conducted to explore the useful index of semi-quantitative estimating left ventricular end-diastolic pressure(LVEDP ,EDP) with transthoracic ultrasound. METHODS:Invasive EDP was measured thr ough a fluid-filled pig-tail catheter in 88 patients. Noninvasive pulmonary ve no us and mitral flow variables were recorded by Doppler ultrasound. RESULTS:Linear regression analysis showed the difference in duration between the pul monary venous A and mitral A wave (PAd-Ad) had the best correlation with EDP ( r=0.73, P<0.01); The duration of the pulonary venous A wave equalling or exceeding the duration of the mitral A wave (that means PAd-Ad≥0) predicted E DP≥15 mm Hg with a sensitivity of 85.1%; a specificity of 90.2%;a positive pred i ctive value of 90.9% and a negative preductive value of 84.1%. CONCLUSION:PAd-Ad≥0 may provide a semi-quantitative index for estimating LVEDP≥15 m m Hg .