关键词: 房间隔缺损, 超声心动图描记术, 压力, 心导管术, 肺动脉收缩压, 肺动脉瓣收缩期跨瓣压差

Abstract: Objective To investigate the role of pulmonary valve pressure gradient in the estimation of pulmonary artery systolic pressures (PASP) in patients with atrial septal defect (ASD). Methods Sixty eight patients with ASD and hospitalized in Tianjin Medical University General Hospital were included in this study. The tricuspid regurgitation pressure gradient method was used for measuring PASP before interventional occlusion operation. And pulmonary valve pressure gradient was measured through pulmonary valve velocity to calculate corrected values (PASP’), which were compared with those (PASPr) obtained by right cardiac catheterization (RHC) respectively. The patients were divided into group A (defect size≤15 mm) and group B (defect size>15 mm) by the size of defect. The measurements obtained by ultrasound echocardiography (UCG) and RHC were compared between the two groups. Results There were statistically significant differences between PASP [(31.66±6.76) mmHg], PASP’[(26.86±6.66) mmHg] and PASPr [(28.79±6.43) mmHg] in group A (P＜0.05). The PASP was significantly higher than PASPr [(45.29±13.49) mmHg vs. (34.56±9.47) mmHg] (P＜0.05), but there was no significant difference between PASP’[(37.30 ± 12.71) mmHg] and PASPr in group B (P＞0.05). Values of PASPr were positively correlated with PASP (r =0.664, 0.588 respectively, P＜0.01) in group A and group B. The correlation coefficients of PASPr and PASP’were improved in two groups after adjusted with pulmonary valve pressure gradient (respectively r =0.700, 0.645, P＜0.01). Conclusion The adjusted PASP calculated by tricuspid regurgitation pressure gradient method with pulmonary valve pressure gradient can improve the accuracy of echocardiographic estimates of PASP in ASD patients with the defect size>15 mm.

Key words: heart septal defects, atrial, echocardiography, stress, cardiac catheterization, pulmonary artery systolic pressure, pulmonary valve pressure gradient