AU - Marcus, J. Tim AU - Westerhof, Berend E. AU - Groeneveldt, Joanne A. AU - Bogaard, Harm Jan AU - de Man, Frances S. AU - Vonk Noordegraaf，安东TI -腔静脉回流和右心室僵硬的肺动脉高血压援助——10.1183/13993003.00625 -2019 DP - 2019 10月01 TA -欧洲呼吸杂志》第六PG - 1900625 - 54 IP - 4 4099 - //www.qdcxjkg.com/content/54/4/1900625.short 4100 - //www.qdcxjkg.com/content/54/4/1900625.full和欧元J2019 10月01;AB -腔静脉回流是肺动脉高压(PAH)右心室衰竭的临床特征。回流可由右心室收缩时的三尖瓣反流或心房收缩时右室舒张充盈受损引起。我们的目的是量化腔静脉的前后血流，并确定肺动脉高压的主要原因。在62例肺动脉高压患者中，心脏磁共振测量了上腔静脉和下腔静脉的容积血流(mL·s−1);流的时间积分得到体积。“后向分数”的定义是腔静脉前向容积与后向容积之比，以百分数表示。最大腔静脉回流时间以心动周期的百分比表示。 Right ventricular volumes and aortic stroke volume were determined. Right heart catheterisation gave right ventricular and right atrial pressures. Right ventricular end-diastolic stiffness was determined with the single-beat method.The median (interquartile range) backward fraction was 12% (3–24%) and it was >20% in 21 patients. Maximum backflow occurred at near 90% of the cardiac cycle, coinciding with atrial contraction. The backward fraction was associated with maximal right atrial pressure (Spearman's r=0.77), right ventricular end-diastolic stiffness (r=0.65) and right ventricular end-diastolic pressure (r=0.77), and was negatively associated with stroke volume (r= –0.61) (all p<0.001).Significant backward flow in the vena cava was observed in a large group of PAH patients and occurred mostly during atrial contraction as a consequence of impaired right ventricular filling due to right ventricular diastolic stiffness. The backward flow due to tricuspid regurgitation was of significance in only a small minority of patients.In 62 patients with pulmonary arterial hypertension, timing of maximal backflow in the vena cava was in late diastole, during the right atrial contraction. The amount of backflow was associated with right ventricular stiffness. Stroke volume was reduced. http://bit.ly/2Y8YKg8