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. 1984 Apr;51(4):407–415. doi: 10.1136/hrt.51.4.407

Analysis of blood flow in pulmonary hypertension with the pulsed Doppler flowmeter combined with cross sectional echocardiography.

M Okamoto, K Miyatake, N Kinoshita, H Sakakibara, Y Nimura
PMCID: PMC481522  PMID: 6231042

Abstract

Blood flow patterns were analysed at nine points in the pulmonary area using the pulsed Doppler technique combined with cross-sectional echocardiography in 53 patients with heart disease and 10 healthy subjects. In subjects with a normal pulmonary artery pressure the blood flow pattern in systole showed a gradual acceleration and deceleration with a rounded summit in mid systole, designated the round type. In patients with pulmonary hypertension it showed a rapid acceleration and early deceleration with a sharp peak in early systole, designated the triangular type. The acceleration time index, defined as the ratio of the time interval from the beginning to the peak of ejection to the ejection time, showed a significant inverse correlation with mean pulmonary artery pressure. In pulmonary hypertension a prominent reverse flow occurred in the right posterior part of the pulmonary trunk during mid-systole and early diastole, indicating the presence of a vortex. Similar flow patterns were also seen in patients with idiopathic pulmonary artery dilatation. The factors responsible for the triangular type were principally the reduced capacitance and increased impedance of the pulmonary vascular tree. Those responsible for the reverse flow were the curved path of the blood flow and dilatation of the pulmonary artery.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker D. W., Rubenstein S. A., Lorch G. S. Pulsed Doppler echocardiography: principles and applications. Am J Med. 1977 Jul;63(1):69–80. doi: 10.1016/0002-9343(77)90119-x. [DOI] [PubMed] [Google Scholar]
  2. Bergel D. H. The dynamic elastic properties of the arterial wall. J Physiol. 1961 May;156(3):458–469. doi: 10.1113/jphysiol.1961.sp006687. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ciobanu M., Abbasi A. S., Allen M., Hermer A., Spellberg R. Pulsed Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency. Am J Cardiol. 1982 Feb 1;49(2):339–343. doi: 10.1016/0002-9149(82)90510-0. [DOI] [PubMed] [Google Scholar]
  4. GLEASON W. L., BRAUNWALD E. Studies on the first derivative of the ventricular pressure pulse in man. J Clin Invest. 1962 Jan;41:80–91. doi: 10.1172/JCI104469. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Goldberg S. J., Areias J. C., Spitaels S. E., de Villeneuve V. H. Use of time interval histographic output from echo-Doppler to detect left-to-right atrial shunts. Circulation. 1978 Jul;58(1):147–152. doi: 10.1161/01.cir.58.1.147. [DOI] [PubMed] [Google Scholar]
  6. Hatle L., Angelsen B. A., Tromsdal A. Non-invasive assessment of aortic stenosis by Doppler ultrasound. Br Heart J. 1980 Mar;43(3):284–292. doi: 10.1136/hrt.43.3.284. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hatle L., Angelsen B., Tromsdal A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation. 1979 Nov;60(5):1096–1104. doi: 10.1161/01.cir.60.5.1096. [DOI] [PubMed] [Google Scholar]
  8. Johnson S. L., Baker D. W., Lute R. A., Dodge H. T. Doppler echocardiography. The localization of cardiac murmurs. Circulation. 1973 Oct;48(4):810–822. doi: 10.1161/01.cir.48.4.810. [DOI] [PubMed] [Google Scholar]
  9. Kalmanson D., Veyrat C., Bouchareine F., Degroote A. Non-invasive recording of mitral valve flow velocity patterns using pulsed Doppler echocardiography. Application to diagnosis and evaluation of mitral valve disease. Br Heart J. 1977 May;39(5):517–528. doi: 10.1136/hrt.39.5.517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Miyatake K., Kinoshita N., Nagata S., Beppu S., Park Y. D., Sakakibara H., Nimura Y. Intracardiac flow pattern in mitral regurgitation studied with combined use of the ultrasonic pulsed doppler technique and cross-sectional echocardiography. Am J Cardiol. 1980 Jan;45(1):155–162. doi: 10.1016/0002-9149(80)90233-7. [DOI] [PubMed] [Google Scholar]
  11. Miyatake K., Okamoto M., Kinoshita N., Matsuhisa M., Nagata S., Beppu S., Park Y., Sakakibara H., Nimura Y. Pulmonary regurgitation studied with the ultrasonic pulsed Doppler technique. Circulation. 1982 May;65(5):969–976. doi: 10.1161/01.cir.65.5.969. [DOI] [PubMed] [Google Scholar]
  12. Miyatake K., Okamoto M., Kinoshita N., Ohta M., Kozuka T., Sakakibara H., Nimura Y. Evaluation of tricuspid regurgitation by pulsed Doppler and two-dimensional echocardiography. Circulation. 1982 Oct;66(4):777–784. doi: 10.1161/01.cir.66.4.777. [DOI] [PubMed] [Google Scholar]
  13. Quinones M. A., Young J. B., Waggoner A. D., Ostojic M. C., Ribeiro L. G., Miller R. R. Assessment of pulsed Doppler echocardiography in detection and quantification of aortic and mitral regurgitation. Br Heart J. 1980 Dec;44(6):612–620. doi: 10.1136/hrt.44.6.612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Reuben S. R. Compliance of the human pulmonary arterial system in disease. Circ Res. 1971 Jul;29(1):40–50. doi: 10.1161/01.res.29.1.40. [DOI] [PubMed] [Google Scholar]
  15. Stevenson J. G., Kawabori I., Guntheroth W. G. Differentiation of ventricular septal defects from mitral regurgitation by pulsed Doppler echocardiography. Circulation. 1977 Jul;56(1):14–18. doi: 10.1161/01.cir.56.1.14. [DOI] [PubMed] [Google Scholar]
  16. Stevenson J. G., Kawabori I., Guntheroth W. G. Noninvasive detection of pulmonary hypertension in patent ductus arteriosus by pulsed Doppler echocardiography. Circulation. 1979 Aug;60(2):355–359. doi: 10.1161/01.cir.60.2.355. [DOI] [PubMed] [Google Scholar]
  17. Thuillez C., Théroux P., Bourassa M. G., Blanchard D., Péronneau P., Guermonprez J. L., Diebold B., Waters D. D., Maurice P. Pulsed doppler echocardiographic study of mitral stenosis. Circulation. 1980 Feb;61(2):381–387. doi: 10.1161/01.cir.61.2.381. [DOI] [PubMed] [Google Scholar]
  18. Veyrat C., Cholot N., Abitbol G., Kalmanson D. Non-invasive diagnosis and assessment of aortic valve disease and evaluation of aortic prosthesis function using echo pulsed Doppler velocimetry. Br Heart J. 1980 Apr;43(4):393–413. doi: 10.1136/hrt.43.4.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Waggoner A. D., Quinones M. A., Young J. B., Brandon T. A., Shah A. A., Verani M. S., Miller R. R. Pulsed Doppler echocardiographic detection of right-sided valve regurgitation. Experimental results and clinical significance. Am J Cardiol. 1981 Feb;47(2):279–286. doi: 10.1016/0002-9149(81)90398-2. [DOI] [PubMed] [Google Scholar]
  20. Young J. B., Quinones M. A., Waggoner A. D., Miller R. R. Diagnosis and quantification of aortic stenosis with pulsed Doppler echocardiography. Am J Cardiol. 1980 May;45(5):987–994. doi: 10.1016/0002-9149(80)90167-8. [DOI] [PubMed] [Google Scholar]

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