RESUMO
@# Objective Toinvestigatetheroleofpulmonaryvalvepressuregradientintheestimationofpulmonary arterysystolicpressures(PASP)inpatientswithatrialseptaldefect(ASD). Methods SixtyeightpatientswithASDand hospitalizedinTianjinMedicalUniversityGeneralHospitalwereincludedinthisstudy.Thetricuspidregurgitationpressure gradientmethodwasusedformeasuringPASPbeforeinterventionalocclusionoperation.Andpulmonaryvalvepressure gradientwasmeasuredthroughpulmonaryvalvevelocitytocalculatecorrectedvalues(PASP’),whichwerecomparedwith those(PASPr)obtainedbyrightcardiaccatheterization(RHC)respectively.ThepatientsweredividedintogroupA(defect size≤15 mm) and group B (defect size>15 mm) by the size of defect. The measurements obtained by ultrasound echocardiography(UCG)andRHCwerecomparedbetweenthetwogroups. Results Therewerestatisticallysignificant differencesbetweenPASP[(31.66±6.76)mmHg],PASP’ [(26.86±6.66)mmHg]andPASPr[(28.79±6.43)mmHg]ingroupA (P＜0.05).ThePASPwassignificantlyhigherthanPASPr[(45.29±13.49)mmHg vs. (34.56±9.47)mmHg](P＜0.05),but therewasnosignificantdifferencebetweenPASP’[(37.30±12.71)mmHg]andPASPringroupB(P＞0.05).Valuesof PASPrwerepositivelycorrelatedwithPASP(r=0.664,0.588respectively,P＜0.01)ingroupAandgroupB.Thecorrelation 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 TheadjustedPASPcalculatedbytricuspidregurgitationpressure gradientmethodwithpulmonaryvalvepressuregradientcanimprovetheaccuracyofechocardiographicestimatesofPASPin ASDpatientswiththedefectsize>15mm.