福村 基之¹, 玉城 繁³, 家永 浩樹³, 檀原 高³, 高本 真一², 鈴木 俊光¹

Motoyuki FUKUMURA¹, Shigeru TAMAKI³, Hiroki IENAGA³, Takashi DAMBARA³, Shinichi TAKAMOTO², Toshimitsu SUZUKI¹

¹公立昭和病院呼吸器科(現国立療養所東京病院呼吸器内科), ²公立昭和病院心臓血管外科, ³順天堂大学呼吸器内科

¹Respiratory Unit, Showa General Hospital, ²Cardiovascular Surgery, Showa General Hospital, ³Department of Respiratory Medicine, Juntendo University, School of Medicine

キーワード : Chronic respiratory disease, Pulmonary arterial pressure, Right heart catheterization, Color-pulsed Doppler echocardiography

In order to noninvasively estimate pulmonary arterial pressure, we examined the clinical validity of a color-pulsed Doppler echocardiography in 17 patients with chronic respiratory disease. We, then compared them with the findings from a right-heart catheterization.
The parameters obtained by the color-pulsed Doppler echocardiography included the pre-ejection period (PEP), the acceleration time (AT) and the ejection time (ET).
The mean pulmonary arterial pressure obtained by a right-heart catheterization showed a high correlation with the PEP/AT (r=0.92).
Although the M-mode echocardiography supplied only qualitative information of the pulmonary arterial pressure, the pulmonary arterial flow spectral analysis by the color-pulsed Doppler echocardiography permitted a quantitative estimate of pulmonary arterial pressure in patients with chronic respiratory diseases.
Aeration of the lung sometimes obstructs right-heart visualization (information about the right heart was inadequate in 15 out of 46 cases in a previous M-mode echocardiographic study); however, once we obtained a pulmonary arterial flow pattern as a color image, we could reliably estimate the pulmonary arterial pressure for the above flow parameters (pulmonary arterial flow pattern could not be determined in only 5 of 46 similar cases).
We, therefore, conclude that the PEP/AT is a useful parameter for estimating the pulmonary arterial pressure, and that the detectability of the pulmonary arterial Doppler signal by a color-pulsed Doppler echocardiography is better than that of the pulmonary arterial valves or right ventricular wall through a M-mode echocardiography in patients with chronic respiratory diseases.