山口 徹¹, 小泉 克己², 原 和弘¹, 磯部 光章³, 町井 潔⁴

Tetsu YAMAGUCHI¹, Katsumi KOIZUMI², Kazuhiro HARA¹, Mitsuaki ISOBE³, Kiyoshi MACHII⁴

¹三井記念病院循環器センター, ²神戸中央市民病院循環器センター, ³東京大学医学部第三内科, ⁴東邦大学医学部第三内科

¹Center for Cardiovascular Disease, Mitsui Memorial Hospital, ²Department of Cardiology, Kobe General Hospital, ³The Third Department of Internal Medicine, University of Tokyo, ⁴The Third Department of Internal Medicine, Toho University

キーワード : Pulmonary hypertension, Doppler flow signal, Rebound pattern, Pulmonary resistance, Acceleration time

　The blood flow in the main pulmonary artery (MPA) was analyzed by contrast echocardiography, pulsed-Doppler technique combined with two dimensional echocardiography and real-time two-dimensional Doppler echocardiography. The Doppler flow signal in patients with pulmonary hypertension showed a rapid acceleration and sharp peak in early systole and the reversed flow in late systole (rebound pattern). This characteristic flow pattern could not be detected in normals and patients with normal MPA pressure, intracardiac shunt and low output state. Patients revealed the "rebound pattern" showed 1) normal or increased cardiac output (normal right ventricular function), 2) elevated MPA pressure, 3) increased pulmonary vascular resistance, and 4) decraesed MPA compliance. According to the analysis of Doppler flow signals of nine sample volumes in MPA, the "rebound pattern" was observed in every sampling points or in the central and medial sites of MPA in patients with pulmonary hypertension.
　The acceleration time (Ta) and right ventricular systolic time intervals were measured from Doppler flow signals. Ta had a good correlation with MPA pressure (r=-0.71, p