Different patterns of notching on doppler graph and hemodynamics in patients with pulmonary hypertension
10.3760/cma.j.issn.1671-0282.2011.03.019
- VernacularTitle:右室流出道血流频谱形态与肺动脉高压血流动力学的关系
- Author:
Tong LIU
;
Yutong CHENG
;
Yihua HE
;
Su WANG
;
Yin TAO
;
Tao SUN
;
Yulong GAO
;
Yun GAO
;
Yuhong MI
;
Zhizong LI
;
Shuang LIU
- Publication Type:Journal Article
- Keywords:
Pulmonary hypertension;
Hemodynamic;
The right ventricular outflow tract Doppler flow velocity envelope (FVERVOT)
- From:
Chinese Journal of Emergency Medicine
2011;20(3):292-296
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate whether simple visual assessment of FVERVOT(the right ventricular outflow tract Doppler flow velocity envelop) graphs aids in hemodynamic differentiation. Method The hemodynamics, echocardiography, and clinical data of 88 patients with pulmonary hypertension (PH) were reviewed. The FVERVOTgraphs were categorized into normal pattern (no notch; NN), late systolic notch pattern (LSN) or mid-systolic notch pattern (MSN). Results The pulmonary vascular resistance (PVR) was highest in the MSN pattern (9.2±3.5 WU; P＜0. 001), in comparison with LSN (5,7 ±3. 1 WU) and NN (3.3±2.4 WU) patterns. The ratio of stroke volume to pulse pressure (compliance) also varied with different patterns of FVERVOr graph (MSN = 1.2 ± 0. 5; LSN = 1.7 ± 0.8; NN = 2.6 ± 1. 7, P = 0.001 and 0.04 respectively compared with NN). The specificity and sensitivity of MSN were 96% and 71%, respectively in case of a PVR ＞ 5 WU (PPV 98%). In the patients with PH, any notching pattern of FVERVOT graph was highly associated with PVR ＞ 3 WU (OR = 22.3, 95 % CI: 5.2 ～ 96.4), whereas the NN pattern predicted a PVR ≤3 WU and pulmonary artery wedge pressure (PAWP) ＞ 15 mmHg (OR =30.2, 95%CI: 6.3 ～ 144.9). Conclusions Visual inspection of the shape of the FVERVOT graphs provides insight into the hemodynamic status of patients with PH.
