小泉 克己¹, 梅田 徹¹, 町井 潔¹, 遠田 栄一², 井田 喜博²

Katsumi KOIZUMI¹, Toru UMEDA¹, Kiyoshi MACHII¹, Eiichi TODA², Yoshihiro IDA²

¹三井記念病院循環器センター, ²三井記念病院循環器検査室

¹Center for Cardiovascular Disease Mitsui Memorial Hospital, ²Central Laboratory Mitsui Memorial Hospital

キーワード : contrast echo pattern, rebound pattern, pulmonary hypertension

The flow patterns in the main pulmonary artery (MPA) were estimated by both M-mode and cross-sectional contrast echocardiography in 19　cases with valvular diseases and　21 cases with congenital anomalies with left to right shunt, and were classified into 3 types in systole and 2 types in diastole. In cases with normal MPA pressure, contrast echos flow from the right ventricular outflow tract (RVOT) to the MPA throughout systole. In cases with severe pulmonary hypertension (PH), the contrast echos in the MPA flow toward the same direction in early systole as in cases with normal MPA pressure. However,the flow direction suddenly reversed in the mid-systole and remained unchanged in the late systole. In cases with mild PH, a mixed pattern of the above two types was observed. Decreased compliance in the pulmonary arterial system, increased pulmonary arterial resistance, and dilatation of the MPA are thought to contribute to the formation of the Rebound Pattern.
　In cases with pulmonary insufficiency, regurgitation of the contrast echos from the MPA to the RVOT in diastole was clearly detected.
　Peak flow rates in the MPA were estimated from the slopes of the contrast echo flows in the M-mode record. The slopes were tend to be greater in cases without PH than those with PH.