Study Of Cardiac Structureand Hemodynamics Characteristics Of Patients With Congenital Heart Disease Complicated With PH By Echocardiographic

Objective: To investigate the cardiac structure and hemodynamics characteristics of patients with congenital heart disease complicated with PH by echocardiographic.Methods :The clinical data of 120 cases of patients with congenital heart disease complicated with PH in Department of ultrasound,Central Hospital of Yongzhou City from January 2015 to January 2017 were retrospectively analyzed.these patients were divided into PH grade ?group(<10u.m2,n=40)and PH II Group(10-17 u.m2,n=40)and PH III group(>17u.m2,n=40)three groups on the basis of pulmonary resistances.The measurement results may be affected by the surface areas,so according to the body surface areas the grade ?group was divided into <0.85m2 and 0.85m2 two groups,the grade ? group was divided into <1.45m2 and 1.45m2 two groups,the grade ? group had similar surface area,so there was no packet.The three groups were given echocardiography,right heart catheterization,and then the results of the examinations,treatment effects were analyzed.At the same time The clinical data of 30 cases of patients with ventricular septal defect and patent ductus arteriosus with PH in our hospital from January 2015 to January 2017 were retrospectively analyzed.Results:The ultrasonic echocardiography BSA,AO,LVPWD,RVAWD,RVD,RVT and RVT/LVT of the three groups were significantly positively correlated with PRV(P<0.05),the A,LVD,LVEF,LVT,FLV and ACT/ET were significantly negatively correlated with PRV(P<0.05),the VSD/PDA,PA,IVS ACT and ET had no correlation with PRV(P>0.05);There was a significant positive correlation between PPR and PRV(P<0.05),but no correlation between PTR and PRV(P>0.05);the differences of PAMP,PVR,QP/QS and SO2 between the three groups were not significant(P>0.05);The oxygen tests of PH grade ?group were positive,the positive rate was 100.0%;The oxygen tests of PH grade ? group positive 8 cases,the positive rate was 20.0%;The oxygen tests of PH grade ? group were negative,the positive rate was 0;The successful closure shunt rate of PH grade ? group was significantly higher than PH grade ? group,PH grade ? group(P<0.05),and the successful closure shunt rate of PH grade ? group was significantly higher than PH grade ? group(P<0.05).Of the 30 cases of patients,10 cases were positive for oxygen inhalation test and 8 cases were successfully closed shunt.The postoperative PAMP decreased by at least 50.0%.The rest of the clinic were judged to have no surgical indications for oral medication.The results of ultrasonic measurement of TPR,PAMP,QP/QS and right cardiac catheterization showed significant positive correlations(r=0.96,0.90,0.90,P<0.05).Ultrasound and right cardiac catheterization were consistent with the guidance of the PH degree and the clinical treatment plan.Conclusion:Echocardiography can be used to study the heart structure and hemodynamic characteristics of patients with congenital heart disease(CHD)complicated with PH,which can accurately reflect the stages and degrees of pulmonary hypertension,and provide reliable basis for clinical classification.At the same time,echocardiography measurement of pulmonary blood flow and pulmonary artery pressure by using ultrasound,the pulmonary and systemic blood flow and total pulmonary resistance,right heart catheterization parameters to get over,as a noninvasive right heart catheterization technique has wide prospect of application.