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Assessment of normal hemodynamic profile of mechanical pulmonary prosthesis by doppler echocardiography: a prospective cross-sectional study.
Cardiovascular Ultrasound ( IF 1.9 ) Pub Date : 2020-05-15 , DOI: 10.1186/s12947-020-00196-0
Maryam Shojaeifard 1 , Ali Daryanavard 1 , Arman Karimi Behnagh 1 , Maryam Moradian 2 , Sajjad Erami 3 , Hossein Dehghani Mohammad Abadi 4
Affiliation  

OBJECTIVES Very few reports have described the Doppler-derived echocardiographic parameters for mechanical pulmonary valve prosthesis (MPVP). This study aims to describe the normal Doppler hemodynamic profile of MPVP using Doppler echocardiography. METHODS The current prospective, single center observational study enrolled 108 patients who underwent pulmonary valve replacement (PVR) surgery for the first time and had a normally functioning prosthesis post-operation. The hemodynamic performance of MPVPs, considering flow dependent and flow independent parameters, was evaluated at two follow-up points, at week one and week four post-operation. All assessments were conducted by an experienced echocardiographer. RESULTS The mean age (±SD) of the participants was 26.4 (±8.98). Tetralogy of Fallot (ToF) was the most common underlying disease leading to PVR, with a prevalence of 88%. At first week post-operation, measurement of indices reported the following values (±SD): peak pressure gradient (PPG): 18.51(±7.64) mm Hg; mean pressure gradient (MPG): 10.88(±5.62) mm Hg; peak velocity (PV): 1.97(±0.43)m/s; doppler velocity index (DVI): 0.61(±18); pulmonary velocity acceleration time (PVAT): 87.35(±15.16) ms; effective orifice area (EOA): 2.98(±1.02) cm2;and effective orifice area to body surface area ratio (EOA/ BSA): 1.81(±0.62) cm2/m2. Comparing these measurements with those obtained from the second follow-up (at week four post-op) failed to hold significant difference in all values except for PVAT, which had increased from its primary value (p = 0.038). Also, right ventricular (RV) function showed significant improvement throughout the follow up period. CONCLUSION The findings of this study help strengthen the previously scarce data pool and better establish the normal values for Doppler hemodynamics in mechanical pulmonary prosthesis.

中文翻译:

多普勒超声心动图评估机械性肺假体正常血流动力学特征:一项前瞻性横断面研究。

目的极少有报道描述了机械肺动脉瓣假体(MPVP)的多普勒超声心动图参数。本研究旨在使用多普勒超声心动图描述MPVP的正常多普勒血流动力学特征。方法当前的前瞻性,单中心观察性研究招募了108例首次接受肺动脉瓣置换(PVR)手术且术后假体功能正常的患者。考虑到血流依赖性和血流无关性参数,MPVP的血流动力学性能在术后的第1周和第4周的两个随访点进行了评估。所有评估均由经验丰富的超声心动图医师进行。结果参与者的平均年龄(±SD)为26.4(±8.98)。法洛四联症(ToF)是导致PVR的最常见基础疾病,患病率为88%。术后第一周,指标测量报告以下值(±SD):峰值压力梯度(PPG):18.51(±7.64)mm Hg;平均压力梯度(MPG):10.88(±5.62)mm Hg; 峰值速度(PV):1.97(±0.43)m / s; 多普勒速度指数(DVI):0.61(±18); 肺速度加速时间(PVAT):87.35(±15.16)ms;有效孔面积(EOA):2.98(±1.02)cm2;有效孔面积与身体表面积之比(EOA / BSA):1.81(±0.62)cm2 / m2。将这些测量值与第二次随访(术后四周)获得的测量值进行比较,除PVAT值(其初始值有所增加)外,所有值均无显着差异(p = 0.038)。也,在整个随访期间,右心室(RV)功能显示出明显改善。结论本研究的结果有助于加强以前稀缺的数据库,并更好地建立机械性肺假体中多普勒血流动力学的正常值。
更新日期:2020-05-15
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