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Pulmonary hypertension(PH)has been defined as mean pulmonary arterial pressure(mPAP）≥25 mmHg at rest,measured by right heart catheterisation. The 6 th WSPH suggested a new pressure level to define an abnormal elevation as the mPAP>20 mmHg and the need for PVR≥3 WU to define the presence of pre-capillary PH. Regarding clinical classification,the main changes were the inclusion in group 1 of a subgroup“pulmonary arterial hypertension(PAH)long-term responders to calcium channel blockers”and a subgroup“PAH with overt features of venous/capillaries involvement“.
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Objective To investigate the effect of aerosol inhalation of iloprost on pulmonary arterial pressure and hypoxic pulmonary vasoconstriction (HPV)during one-lung ventilation (OLV) in rats.Methods Thirty male rats were randomly divided into three groups,10 in each group. Models of lung perfusion were established,100% FiO 2 was ensured under the condition of OLV and the atomizers were opened.Atomization inhalation with normal saline was performed in group A,ilo-prost at a concentration of 0.05 μg·kg-1 ·min-1 in group B and iloprost at a concentration of 0.1μg·kg-1 ·min-1 in group C.Mean pulmonary artery pressure (MPAP)and PaO 2 of drainage-fluid from left atrium were recorded at time points of perfusion for 10 min (T1 ),aerosol inhalation for 10 min (T2 )and OLV for 1 h (T3 ).Oxygenation index (OI)was calculated with PaO 2 at each time point.Both lungs were harvested for electronic microscope detection.Results MPAPs at T2 and T3 were higher in contrast with that at T1 (P <0.05).A decrease of MPAP at T2 and T3 showed in group B and C when compared with those in group A (P <0.05).Group C had lower MPAP in comparison with group B at each time point.Considering the time span,we found that OIs at T2 and T3 were lower than that at T1 .In addition,OIs at T2 and T3 in group C were higher than those in group B,respectively.Under elec-tronic microscope,nuclear membranes typeⅡ alveolar epithelial cells of both lungs in group A and of non-ventilated lungs in group B and C bulged out or invaginated and lamellar bodies were evacuated,especially when compared to those in ventilated lungs in groups B and C.Conclusion In rat models of lung perfusion, atomization inhalation with iloprost can decreased MPAP,reduce intrapulmonary shunt and increase oxygen-ation.
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Objective To compare the cardiac function and pulmonary arterial pressure of the patients undergoing surgery of off-pumpcoronary artery bypass grafting(CABG) and on-pump-CABG by the esophageal ultrasound and the floating catheter,to find out what kind of coronary artery bypass grafting is better for cardiac function.Methods The design of this experiment used a completely randomized block design,36 patients were randomly divided into two groups:group A(off-pump-CABG),group B (on-pump-CABG),18 cases in each group.The detection time point set after all the operation had been completed.The pulmonary arterial systolic pressure,the right ventricular end diastolic volume,the right ventricular ejection fraction and the left ventricular end diastohc pressure were measured by the esophagus ultrasound and floating catheter.Results There was no significant difference in esophagus ultrasound and floating catheter between the two groups (P ＞ 0.05).The results of echocardiography and floating catheter showed that the pulmonary artery diastolic blood pressure was lower in group A than that in group B (P ＜ 0.05).The heart function in group A was better than that of group B (P ＜ 0.05).Conclusion The effect of the ultrasonic heartbeat graph and the monitoring of the floating catheter in the off-pump-CABG and on-pump-CABG are basically the same.The heart function in off-pump-CABG group was better than that of on-pump-CABG.The reason may be that the off-pump-CABG is less likely to be associated with the flow dynamics of the blood flow dynamics and the cell factor associated with the non physiological ducts.
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OBJECTIVE:To systematically evaluate the effects of atorvastatin on pulmonary function,pulmonary arterial pres-sure and related indexes in patients with stable chronic obstructive pulmonary disease(COPD),and to provide evidence-based refer-ence. METHODS:Retrieved from Cochrane Library,PubMed,EMBase,CJFD and VIP,randomized controlled trials(RCTs)about atorvastatin combined with conventional therapy(trial group)vs. conventional therapy alone(control group)in the treatment of sta-ble COPD were collected. Meta-analysis was performed by using Rev Man 5.3 statistical software after data extraction and quality evaluation by Cochrane Handbook Manual 5.1.0. RESULTS:Totally 7 RCTs were included,involving 371 patients. Results of Me-ta-analysis showed,FEV1 [MD=0.07,95%CI(0.04,0.09),P<0.001],FEV1%pred [MD=6.18,95%CI(2.23,10.12),P=0.002] and 6MWD [MD=55.31,95%CI(36.44,74.18),P<0.001] of trial group were significantly higher/longer than those of con-trol group;pulmonary artery systolic pressure [MD=-6.78,95%CI(-11.62,-1.94),P=0.006],mean pulmonary artery pres-sure [MD=-6.61,95%CI(-7.26,-5.96),P<0.001],St. George respiratory questionnaire [MD=-13.21,95%CI(-23.90,-2.52), P=0.02] were significantly lower than control group,with statistical significance. There was no statistical difference in FEV1/FVC [MD=3.73,95%CI(-2.08,9.55),P=0.21] or hs-CRP [MD=0.29,95%CI(-1.37,1.95),P=0.73] between 2 groups. CONCLU-SIONS:Atorvastatin can significantly improve pulmonary function and pulmonary arterial pressure in patients with stable COPD, and can improve the quality of life.
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Aim To optimize the traditional method of right catheterization in rats and establish a rapid , stable and reliable method of the right heart catheter guided intubation to measure pulmonary artery pressure. Methods Nighty male wistar rats were used to optimize the method of detection of pulmonary arte-rial pressure. Three catheter namely PE50, PU I, and PU II were used for choosing the best intubation. The new technology of right catheterization was established and used for the research of pulmonary arterial hypertension. Results The PU I catheter was obviously better than PE50 and PU II catheter in the success rate and measurement time ( P <0. 05 ) . The method of right heart catheter guided intubation was significantly superior to the traditional right heart direct intubation (P<0. 05 or P<0. 01). After improving the right catheterization, the detection of hemo-dynamic indexes in PAH-model rat was successful with regular pressure curve and reliable experimental data. Conclusions The right heart catheter guided intubation method has a high suc-cess rate and it can detect the pulmonary artery pressure quick-ly, easily, and can help other researchers to complete experi-ment as efficiently as possible.
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Objective to investigate the relationship between the size of ostium secondary atrial septal defect (ASD) and the pulmonary arterial pressure (PAP) in children less than 5 years of age. Methods During the period from April 2000 to January 2011, a total of 189 child patients less than 5 years of age with ostium secondary ASD were admitted to General Hospital of Shenyang Military Command. Under general anaesthesia with ketamine cardiac catheterization was performed, PAP was measured, and percutaneous occlusion of ASD was carried out in all patients. The clinical indexes, including sex, age, body height, body weight, body surface area, diameter of ASD defect, heart- to- thorax ratio, the systolic, diastolic and mean pressure of the pulmonary artery, etc. were determined. The patients were followed up for one year and postoperative cardiac ultrasonography was performed to check the results. The patients were divided into groups according to the defect size. Results The 189 patients consisted of 77 males and 112 females with a male-to-female ratio of 1 ∶ 1.5. The mean age was (4.1 ± 0.9) years old, ranging from 2 to 5 years old. The mean weight was (17.2 ± 3.6) kg, ranging from 10.0 to 30.0 kg. The mean height was (104.9 ± 9.2) cm, ranging from 77 to 135 cm. The mean body surface area (BSA) was (0.71 ± 0.10) m2, ranging from 0.46 to 1.02 m2. The mean size of ASD was (12.6 ± 4.8) mm, ranging from 5 to 29 mm. The mean size of ASD, which was modified by BSA, was (18.0 ± 7.0) mm/m2, ranging from 5.3 to 38.9 mm/m2. The mean systolic PAP was (41.1 ± 8.9) mmHg with a range of 15 - 67 mmHg. The mean diastolic PAP was (16.8 ± 6.5) mmHg with a range of 3 - 45 mmHg. The mean PAP was (24.9 ± 6.7) mmHg with a range of 12 - 48 mmHg. One hundred and fifty- nine patients (89.4%) had pulmonary arterial hypertension (PAH) which was determined by right heart catheterization, but no patient showed PAH when the pulmonary arterial pressure was measured by echocardiography before the procedure as well as 1, 3, 6, 12 months after the procedure. No definite correlation existed between the size of ASD and the pulmonary artery pressure (P > 0.05). Conclusion Pulmonary artery pressure measured by right heart catheterization has no definite correlation with the size of ASD in children less than 5 years of age. Pulmonary artery pressure obtained from right heart catheterization is higher than that determined by cardiac ultrasonography, which may be caused by the effect of ketamine when general anaesthesia is used in performing right heart catheterization.
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It is well established that pulmonary vascular resistance plays a pivotal role in the postnatal decrease of pulmonary arterial pressure in neonates.Catheterization has been demonstrated that mean pulmonary arterial pressure(PAP) equals or exceeds systemic for as long as 1 hour after birth.Thereafter,a gradual decrease in pressure occurs with the major fall taking place during the first 24 hours.By 3 days of age,the mean pulmonary arterial pressure is less than 50 per cent of that in the systemic circulation.Tricuspid regurgitation(TR) and ductal flow velocity(PDA) have the largest number of confidence steps in the expected range of values.The most repeatable technique is TR,but PDA might also be useful for a serial studies owing to the potential for large change.This paper reviews the PAP of normal full-term infants after birth by catheterization and Doppler ultrasound,in order to provide some clinic basis for pulmonary hypertension identification.
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The aim of this study was to illustrate the surgical implantation of Swan Ganz introducers into the jugular vein, as well as the pulmonary artery cannulation procedure using ten mixed breed (MB) adult horses. We also proposed to demonstrate pulmonary arterial pressure (PAP) values measured through the implanted Swan Ganz during one incremental submaximal exercise test performed on a treadmill. Surgical implantation of the Swan Ganz introducers has demonstrated to be easy and quick to perform. None of the animals showed signs of discomfort following the surgery and ergometric test was carried out as proposed. PAP increased proportionally with exercise intensity, and the major average values were recorded at the higher effort time points. The PAP average values increased (P<0.05) when treadmill speed reached 7.5m/s (39±3mmHg) and 8.5m/s (41±3mmHg), comparing to average values at rest (26±3mmHg). However, the PAP values observed at the maximal effort performed by the MB horses of this trial (41±3mmHg), are under the values described for other breeds at similar effort tests. The technique described in the present study contributes for the standardization of research protocols using arterial pulmonary access via Swan Ganz catheter implantation in horses. The ergometric test was effective to promote PAP changes according to the effort, showing PAP values for MB horses that can guide further investigations.
Objetivou-se ilustrar a técnica cirúrgica de implantação de introdutores para cateter de Swan Ganz na veia jugular, bem como o procedimento de canulação da artéria pulmonar de dez equinos adultos sem raça definida (SRD). Realizando medidas através do cateter de Swan Ganz implantado, objetivou-se ainda demonstrar os valores de pressão arterial pulmonar (PAP) durante um teste de esforço progressivo de intensidade submáxima realizado em esteira rolante. A técnica cirúrgica de implantação de introdutores para o cateter de Swan Ganz empregada, demonstrou-se de fácil e rápida realização. Os animais não apresentaram complicações frente ao introdutor implantado e o teste ergométrico foi realizado conforme proposto. A PAP se elevou ao longo do exercício seguindo o incremento de velocidade, sendo os maiores valores médios observados nos momentos de maior intensidade do esforço. Os valores médios de PAP aumentaram (p<0,05) às velocidades de 7,5m/s (39±3 mmHg) e 8,5m/s (41±3 mmHg), quando comparados aos valores mensurados no repouso (26±3mmHg). Entretanto, os valores de PAP encontrados no máximo de esforço realizado pelos equinos SRD deste ensaio (41±3mmHg), encontram-se abaixo dos valores descritos para outras raças para a mesma intensidade de esforço. A descrição detalhada da técnica ilustrada no presente trabalho, pode contribuir substancialmente na padronização de protocolos experimentais que propõem o acesso arterial pulmonar por meio da implantação de cateter de Swan Ganz em equinos. O teste ergométrico proposto foi eficaz em promover variações de PAP de acordo com o esforço realizado, demonstrando valores para equinos SRD que poderão ser usados como base para futuras avaliações.
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Animales , Presión Arterial , Catéteres de Permanencia/veterinaria , Caballos/fisiología , Procedimientos Quirúrgicos Operativos , Prueba de Esfuerzo/veterinaria , Actividad Motora/fisiología , Esfuerzo Físico/fisiología , Arteria PulmonarRESUMEN
ObjectiveTo analyze the perioperative risk factors of right heart failure (RHF) in human heart transplantation, and to summarize the efficacy of targeted agent especially on pulmonary hypertension.Methods Patients underwent heart transplantation were selected by exclusion criteria : (1) acute heart or other organ failure, or supported by mechanical assist device ; (2) the difference between the body weight of donor and recipient was ＞ 20％ ; (3) the ischemic time of donor was＞ 6 h; (4) acute rejection episode after transplantation; (5) perioperative death.The clinical data of 96 patients were collected, including gender, age, body weight, protopathy, history of heart failure, preoperative systolic pulmonary arterial pressure (SPAP), left ventricle end diastolic diameter (LVEDD), preoperative ejection fraction(LVEF), preoperative blood creatinine, donor ischemic time and preoperative application of 5-PDEs.The diagnosis standard of RHF was established.The risk factors were analyzed through Logistic Regression.Patients were divided into two groups according to the systolic pulmonary arterial pressure (SPAP).In group A, SPAP was ＜40 mm Hg, and in group B with SPAP≥40 mm Hg.The correlation between two groups was tested byχ2 test.ResultsIn the multivariable analysis, age, history of valve disease, length of heart failure,and preoperative SPAP were the risk factors of RHF with the coefficient of 1.051, 1.351, 1.712 and 6.725, respectively.SPAP seems to be the most important risk factor.Coronary artery disease and preoperative application of 5-PDEs-I were the favorable factors with the coefficient of 0.056 and 0.034, respectively.Parameters regarding age, history of valve disease, length of heart failure between the two groups were significantly different.There were no significant differences in gender, body weight, diagnosed as dilated cardiomyopathy or coronary artery disease and other etiologies, preoperative LVEDD, preoperative EF, preoperative blood creatinine, isehemic time and RHF, though the incidence of RHF in group B was higher than in group A (67.6％ vs 45.8％).There was also no statistic difference in using of ECMO and the mortality rate between two groups.ConclusionPreoperative PAP was the main risk factor of the RHF after heart transplantation.Although there was no statistic difference, the incidence of RHF in patients with SPAP≥40 mm Hg was higher than in patients with SPAP ＜40 mm Hg .The application of targeted agent therapy and ECMO may be helpful in treating RHF after heart transplantation.
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Objective To evaluate the therapeutic effect of spironolactone on schistosomal pulmonary arterial hypertension(SPAH). Methods A total of 62 patients suffered from hepatosplenic schistosomiasis with pulmonary arterial hypertension were divided into the spironolactone group(n=31) and control group (n=31). All the patients underwent serial echocardiography and the clinical effect before and after the treatment was evaluated by assessing the mean pulmonary arterial pressure (mPAP) and pulmonary arterial diameter (PAD). At the same time, the varieties of the clinical symptoms, signs and the distance of the 6-minute walking test (6-MWT) were investigated. Results In spironolactone group, mPAP(-x±s) decreased from (31.8±7.1) mmHg to (21.2±2.1) mmHg, PAD(-x±s) decreased from (28.0±5.0) mm to (20.0±3.5) mm before and after the treatment respectively(P<0.01). There were significant differences in mPAP, PAD, the distance of 6-MWT and the heart function before and after the treatment in the spironolactone group. However, the data did not show the significant difference in the control group. Conclusion The therapeutic effect of spironolactone in the treatment of SPAH is satisfactory.
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Objective To evaluate the efficiency of inhaling penehyelidine hydyoehloride(PHC)in reducing pulmonary arterial pressure and improving lung funetion in patients with acute exaeerbation of ehronie obstruetive pulmonary disease(AECOPD).Methods Sixty patients with AECOPD were randomly divided into the control group(30 patients) and the treatment group(30 patients).The patients in treatment group inhaled PHC,and patients in control group inhaled diprophylline.The pulmonary arterial pressure was measured before and after inhalation.The peak expiratory flow(PEF) and forced expiratory volume in one second(FEV1)was measured at different time points before and after inhalation. Arterial blood gas and,symptoms were also observed.Results The pulmonary arterial pressure in treatment group was reduced by 20% and reduced by 5% in the control group.FEV1 and PEF were improved after inhalation,the average increase of FEV1 was 350 ml(P＜0.01),and PEF was improved by 37 L/min(P＜0.05).Arterial blood gas analysis was improved,and PaO_2 increased by 18 mmHg(P＜0.01).The respiratory rate and the symptoms of cough and sputum were also improved.Conclusion PHC improved the lung function of patients with AECOPD by reducing the pulmonary arterial pressure.
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BACKGROUND: Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive inotropic effects that has not been evaluated widely in pediatric patients with intracardiac left to right shunts. The present study was performed to evaluate the hemodynamic effects of amrinone in infants and children with intracardiac left to right shunts. METHODS: Twenty patients (aged 2 months to 24 months) who underwent open heart surgery to correct one or more intracardiac left to right shunts were evaluated. Before cardiopulmonary bypass, a 22 gauge angiocatheter was placed at the main pulmonary artery by surgeons to measure pulmonary arterial pressure. Patients with a mean pulmonary arterial pressure or = 25 mmHg were assigned to Group B (n = 10). Mean systemic arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP) and heart rate (HR) were measured before loading of amrinone (3 mg/kg), 5 minutes, and 15 minutes after continuous infusion of amrinone (10 microgram/kg). The mean pulmonary arterial pressure to mean systemic arterial pressure ratio (MPAP/MAP) and rates of changes of mean arterial pressure (delta MAP) and mean pulmonary arterial pressure (delta MPAP) were calculated. RESULTS: Amrinone reduced MAP, MPAP, CVP and increased HR. MPAP/MAP increased in Group A but decreased in Group B (P < 0.05). In Group A, delta MAP was significantly greater than that of Group B (P < 0.005). In Group B, delta MPAP was significantly greater than that of Group A (P < 0.005). CONCLUSION: In infants with intracardiac left to right shunts, amrinone reduces MAP, MPAP, CVP and increases HR. Amrinone appears to have a potent vasodilating effect on the pulmonary artery in infants with pulmonary hypertension. However, more hemodynamic measurements such as cardiac output, vascular resistance and doppler echocardiographic study are necessary to evaluate the hemodynamic effects of amrinone precisely.
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Niño , Humanos , Lactante , Amrinona , Presión Arterial , Gasto Cardíaco , Puente Cardiopulmonar , Presión Venosa Central , Ecocardiografía , Frecuencia Cardíaca , Hemodinámica , Hipertensión Pulmonar , Arteria Pulmonar , Cirugía Torácica , Resistencia VascularRESUMEN
As the mitral valve disease becomes long-standing, the patient may develop pulmonary hypertension. It was reported that after surgical correction, the elevated pulmonary vascular resistance(PVR) would fall quickly in association with the fall in left atrial pressure(LAP). This study was performed to evaluate the changes in mean pulmonary artery pressure(PAP) and PVR immediately after mitral valve replacement(MVR). Fifty six patients undergoing mitral valve replacement(MVR) were divided into two groups on the basis of the presence or absence of significant pulmonary hypertension, defined as a resting mean pulmonary arterial pressure greater than 30mmHg. After induction of anesthesia, PAP, PVR, cardiac output(CO) were measured and compared with values in postbypass period. PAP and PVR were significantly decreased(PAP from 39.64+/-1.88 to 29.18+/-1.65 mmHg, P 0.001, PVR from 6.16+/-1.14 to 3.53+/-0.62 units, P or = 30mmHg, n=23), whereas not changed in Group I(PAP30 mmHg, n=33)(P<0.05). Persistance of an elevated PVR may cause right ventricular failure and low-output syndrome, so that an attempt to reduce the PVR is needed postoperatiavely. This study demonstrated that the PAP and PVR fall significantly after MVR especially in patients with severe pulmonary hypertension.
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Humanos , Anestesia , Presión Arterial , Hipertensión Pulmonar , Válvula Mitral , Arteria Pulmonar , Resistencia VascularRESUMEN
In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
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Animales , Perros , Presión Arterial , Presión Atrial , Autopsia , Catéteres , Gases , Atrios Cardíacos , Frecuencia Cardíaca , Hemodinámica , Concentración de Iones de Hidrógeno , Venas Yugulares , Leucocitos , Modelos Teóricos , Mortalidad , Pancuronio , Pentobarbital , Pronóstico , Arteria Pulmonar , Embolia Pulmonar , Presión Esfenoidal Pulmonar , Termodilución , TransductoresRESUMEN
This study was carried out to determine the accuracy of Doppler echocardiography for predicting the pulmonary arterial pressure from right ventricular systolic time intervals in 52 patients with ventricular septal defect. The diagnosis of ventricular septal defect was made by cardiac catheterization and angiocardiography at Dong San hospital, Keimyung University during the period of one year from jan. 1988 to Dec. 1988. Doppler measurements of acceleration time (AT), right ventricular ejection time (RVET), right ventricular preejection period (RPEP), AT/RVET, and RPEP/AT were compared with pulmonary arterial pressure (PAP), measured by cardiac catheterization. The patients were divided into 3 groups : PAP or =60mm HG, AT was 0.06+/-0.01sec. AT/RVET was 0.28+/-0.05. RPEP/AR was 1.51+/-0.21. As the level of PAP increased, Doppler AT, AT/RVET and RPEP/AT showed significant change(P<0.001). 3) The Doppler AT showed relative high correlation(r=-0.76) with PAP measured by cardiac catheterization in all group. 4) The Doppler AT/RVET showed correlation(r=-0.70) with PAP. 5) The Doppler RPEP/AT showed high correlation(r=0.91) with PAP. The Doppler echocardiography was easy to apply in all age groups, and was found useful for detecting pulmonary hypertension in ventricular septal defect and for the follow-up check of the patients. It may help to determine the optimal time for surgery and evaluation of the treatment.
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Humanos , Aceleración , Angiocardiografía , Presión Arterial , Cateterismo Cardíaco , Catéteres Cardíacos , Diagnóstico , Ecocardiografía , Ecocardiografía Doppler , Estudios de Seguimiento , Defectos del Tabique Interventricular , Hipertensión Pulmonar , SístoleRESUMEN
Fifty nine patients who had been admitted to Seoul National University Hospital from April to October in 1986 were prospectively examined by a pulsed Doppler echocardiography on one day before cardiac catheterization. The sample volume was placed both just proximal and distal to pulmonic valve on 2-D echocardiogram. 1) Among the three morphologic patterns of the flow velocity, triangular and intermediate types indicate pulmonary hypertension (sensitivity 84%, specificity 86%), and round type indicates normal pulmonary arterial pressure (sensitivity 86%, specificity 84%). 2) In the group with pulmonary hypertension acceleration time and ejection time were measured shorter (P<0.01), and prejection period was measured longer than the group without pulmonary hypertension (P<0.05). 3) The best correlation was obtained between PEP/AT and mean pulmonary arterial pressure (r=0.77). Acceleration time alone also correlated well with mean arterial pulmonary pressure(r=-0.69). 4) In STI measurement and its correlation with pulmonary arterial pressure, no significant difference was observed when recorded in main pulmonary artery or right ventricular outflow tract. But in the latter position, late, systolic fluttering and variation in curve morphology occured less likely. 5) Our results indicate that the pulsed Doppler echocardiography is useful not only in the diagnosis of pulmonary hypertension but also in the quantitative estimation of pulmonary arterial pressure in different heart diseases. Futhermore this method may be a good tool for follow-up evaluation after surgical or medical treatment of patients with pulmonary hypertension.
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Humanos , Aceleración , Presión Arterial , Cateterismo Cardíaco , Catéteres Cardíacos , Diagnóstico , Ecocardiografía Doppler , Ecocardiografía Doppler de Pulso , Cardiopatías , Hipertensión Pulmonar , Estudios Prospectivos , Arteria Pulmonar , Sensibilidad y Especificidad , SeúlRESUMEN
The effects of physical activity on cardiopulmonary hemodynamics under acute hypoxia at a simulated altitude of 4000 meters were studied in 8 conscious goats. It is known that acute hypoxia alone can result in an elevation of pulmonary arterial pressure and acceleration of heart rate, but no obvious effects on cardiac output and systemic arterial pressure, and physical activity can increase the pulmonary arterial pressure, cardiac output and heart rate at sea level. It was found that a combination of physical activity and a simulated altitude of 4000m could bring about a more marked increase of cardiac output and heart rate but no further increase of pulmonary arterial pressure. The latter phenomenon might be due to increased alkalinity of the arterial blood underhypoxic condition.