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승모판막 질환에서의 Doppler 심초음파도를 이용한 확장기 좌심방-좌심실 평균 압력차에 대한 연구
박영배,서정돈,이영우,김효수,도문흥,오병희 대한내과학회 1987 대한내과학회지 Vol.32 No.2
Diastolic LA and LV pressure gradient was determined with doppler echocardiography in 35 patients with mitral valvular heart disease and was compared with that determined with cardiac catheterization. In 23 patients who underwent mitral valvular replacement, pre and postoperative pressure gradients were observed, Correlation between pressure gradient and pressure half time was investigated with Doppler echocardiography. The results were as follows; 1) 1n total 35 patients with MVHD, mean ΔP in Doppler and cath were 15.8±6.3 (mean±S.D.) mmHg and 17.0±6.7mmHg, respectively, and the correlation coefficient was 0.91. 2) In 15 patients with pure MS, mean ΔP in Doppler and cath, were 15.5±6.1mmHg and 16.1±5.6mmHg, respectively, and the correlation coefficient was 0.90. 3) In 23 patients who underwent MVR, preop ΔP and postop Δ4P were 17.0±6.2mmHg and 2.2±0.9mmHg, respectively, and the difference was significant. 4) In 13 patients with Ionescu Shiley valve, ΔP and T were 2.1mmHgSl.lmmHg, and 110±50msec respectively. In 9 patients with St. Jude valve, ΔP and T1/2 were 2.3±0.7mmHg and 65±22msec, respectively, 5) The correlation coefficient between ΔP and T1/2 was 0.48 in total 35 MVHD and 0.57 in 15 pure MS. The correlation coefficient between ΔP divided by cardiac index and T1/2 f, was 0.63 in 15 pure MS. Therefore, Doppler echocardiography is a useful noninvasive diagnostic tool for measurement of the pressure gradient between LA and LV in MVHD, and can be used to assess the severity of preop, MVHD and postop. result and to follow up patients after operation.
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