| Objectives:To analyze the correlation between the pulmonary arteriosus(arteriosus)noise,cardiac ultrasound estimation of pulmonary artery pressure,right heart catheter measurement of pulmonary artery pressure and pulmonary vascular resistance in adult PDA(patent ductus arteriosus)patients with pulmonary hypertension,and the clinical significance of adult PDA attempted occlusion.To explore the clinical features of adult patent ductus arteriosus,and to provide the possibility and reliability of interventional therapy for adult patients with medium and severe pulmonary hypertension PDA,so that patients can get reasonable treatment.Methods:Case data of adult PDA patients with pulmonary hypertension admitted to the department of cardiolog,y of our hospital from June 2018 to March 2019 were selected as the research objects,according to include and exclude criteria were included in 38 cases,including age,36.41+/-10.53 years,women in 27 cases,11 cases,men at 159.2+/-6.26 cm,54.94+/-7.44 kg weight,all cases of preoperative cardiac auscultation check-up,echocardiography,right cardiac catheterization,aorta angiography,try plugging and relevant test results,verify artery catheter was not closed.1.To analyze the relationship between the adult PDA heart murmur and the real pulmonary artery pressure measured by the right cardiac catheter.2.To analyze the relationship between color doppler ultrasound and pulmonary artery pressure measured by right heart catheter in adult PDA.3.To analyze the relationship between pulmonary arterial pressure estimated by cardiac ultrasound and pullmonary vascular resistance estimated by right cardiac catheter in adult PDA was analyzed.4.To analyze the decrease of pulmonary artery pressure in adult PDA.Results:The trial occlusion test was performed on 38 adult PDA study cases.2 cases abandoned the occlusion due to the large shunt after the trial occlusion and the increased pulmonary artery after the trial occlusion respectively.Other cases were successfully treated with occlusion.1.Nature of a heart murmur and right cardiac catheterization pulmonary artery pressure correlation analysis:r=0.778,P<0.05,r was statistically significant,there is positive correlation,that is:with the noise properties from continuous murmur,dual phase noise group group,no noise,isolated systolic murmur in turn changes,pulmonary artery pressure is positively related to the trend of increase.2.Comparison of t-test of pulmonary artery pressure measured by transthoracic ultrasound and right cardiac catheter:T=-1.729,P=0.093,P>0.05,the difference was not statistically significant.It can be considered that there was no difference in pulmonary artery systolic pressure measured by transthoracic cardiac ultrasound and right cardiac catheter.Comparison of the correlation between cardiac ultrasound and pulmonary artery pressure measured by right cardiac catheter:the correlation coefficient r of the total group,the mild group and the severe group were 0.918,0.678 and 0.750,respectively,all P values were less than<0.05,and the difference was statistically significant.The correlation of the severe group was r=0.598,P=0.052,P>0.05,and the difference was not statistically significant.It can be concluded that there is a positive correlation between the total group,mild group and moderate group and the pulmonary artery pressure measured by right heart catheter,while there is no correlation between the pulmonary artery pressure measured by right heart catheter and the cardiac ultrasound in severe group.3.Comparison of the correlation between pulmonary artery pressure measured by cardiac ultrasound and pulmonary small blood vessel resistance:the overall comparison between pulmonary artery pressure measured by cardiac ultrasound and pulmonary small blood vessel resistance was r=0.795,P<0.05,and the difference was statistically significant.Compared with the mild group,the moderate group and the severe group,the cardiac ultrasound pulmonary artery pressure and pulmonary small blood vessel resistance r were 0.398,0.077 and 0.221,respectively.The P values were all>0.05,and the differences were not statistically significant.It can be concluded that there is a positive correlation between total cardiac ultrasound pulmonary artery pressure and pulmonary small blood vessel resistance,while there is no statistical significance between other groups.4.Try to block the pulmonary artery pressure decline analysis:this study selected 36 cases before plugging the right cardiac catheterization measured pulmonary artery systolic pressure was 66.33+/-32.29 mmHg,try to block the right cardiac catheterization after measured the pulmonary artery pressure was 41.13+/-17.84 mmHg.sealing pressure drop before and after the value of 22.19+/-17.07 mmHg and 31.48+/-13.05%drop in the pulmonary artery systolic pressure,pulmonary artery systolic pressure drop after sealing,the difference was statistically significant(P=0.001<0.05).Among them,the pulmonary artery systolic blood pressure of 13 patients with severe pulmonary hypertension decreased by 35.53 16.56mmHg after trial occlusion,and all of them decreased by 20%or more than 30mmHg.Conclusions:1.Changes in the murmur properties of adult PDA patients with PAH may serve as a preliminary judgment for predicting pulmonary arterial hypertension and its degree at the initial screening2.Although echocardiographic estimation of pulmonary artery pressure is positively correlated with right cardiac catheter pressure,assessment of right cardiac catheterization,especially pulmonary vascular resistance,in adult PDA patients with PAH is of great clinical significance for such patients.3.Measurement of pulmonary vascular resistance in right cardiac catheter is one of the important means to exclude adult patients with left cardiac function disease combined with PDA at the same time,which has important clinical significance for clinical treatment evaluation and treatment selection of such patients4.For adult PDA patients with PAH but still undergoing occlusion,intraoperative trial occlusion to observe pressure changes has important prognostic value. |
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