An Alternative Method for Perioperative Estimation of Pulmonary Artery Systolic Pressure by Echocardiography.

[摘要] Background:Intheperioperativesetting,pulmonaryhypertensionisduetoischemia,left-sidedvalvularregurgitationandstenosis,residualshunt,pulmonaryemboli,pericardialeffusionetc.Thepulmonaryartery(PA)pressurecanbeassessedbydifferentmethods,includinginvasivepulmonarycathetersandpulsedDopplerechocardiography.BecauseoflimitationsofDopplerechocardiography(conventionalmethod)forevaluationofPApressure,wepurposedthisstudytodeterminewhethertricuspidannularplanesystolicexcursion(TAPSE),isovolumicrelaxationtime(IVRT)andS-wavevelocityobtainedbytissueDopplerimaging(TDI)canbeusedasindicesofsystolicpulmonaryarterypressureinperioperativesetting.MaterialsandMethods:Simultaneously,TAPSEby2-DechocardiographyandtissueDopplervelocity(TDV)studybyDopplerechocardiographyandrightheartcatheterizationbySwan-Ganzcatheterwereperformedin55patients(meanage46years,30weremale)withleft–sidedvalvulardisease(n=25),ischemicheartdisease(n=18)andadult-congenitalheartdisease(n=12).TheTAPSEindex,whichisexpressedasanabsolutevalue(cmormm),IVRTandS-wavevelocitybyTDIweremeasured.Wealsomeasuredpulmonaryarterysystolicpressurebyrightcardiaccatheterization.Results:Inpatientswithmoderateandseverepulmonaryhypertension(PASP>45mmHg)theTAPSEvaluewas<17.8mmwithsensivityof90%andspecifityof80%,theS-wavevelocitywas79mswithsensitivityof93%andspecificityof95%(p

[学科分类] 基础医学

[关键词] Pulmonary Artery Systolic Pressure;Echocardiography.