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Abstract：
Bubble contrast echocardiography is commonly used to diagnose pulmonary arteriovenous malformations (PAVMs) in single ventricle congenital heart disease (CHD), yet previous studies inconsistently report a correlation between bubble echoes and oxygenation. In this study, we sought to re-evaluate the correlation between bubble echoes and oxygenation by assessing total bilateral shunting and unilateral shunting. We conducted a single-center, retrospective study of patients with single ventricle CHD and previous Glenn palliation who underwent a cardiac catheterization and bubble echocardiogram during the same procedure from 2011 to 2020. Spearman\'s rank correlation was performed to examine the relationship between total bilateral shunting and measures of systemic oxygenation, as well as unilateral shunting and ipsilateral pulmonary vein oxygenation. For all patients (n = 72), total bilateral shunting moderately correlated with peripheral oxygen saturation (SpO2) (rs = -0.44, p < 0.0001). For patients with Glenn/Kawashima circulation (n = 49), total bilateral shunting was moderately correlated (SpO2: rs = -0.38, p < 0.01). In contrast, unilateral shunting did not correlate with ipsilateral pulmonary vein oxygenation for any vein measured (p = 0.16-p > 0.99). In conclusion, the total burden of bilateral bubble shunting correlated with systemic oxygenation and may better reflect the total PAVM burden from all lung segments. Unilateral correlation may be adversely influenced by non-standardized approaches to pulmonary vein sampling.
摘要：
气泡对比超声心动图通常用于诊断单心室先天性心脏病（CHD）的肺动静脉畸形（PAVMs）。然而，以前的研究并不一致地报道了气泡回声和氧合之间的相关性。在这项研究中,我们试图通过评估总的双侧分流和单侧分流来重新评估气泡回声与氧合之间的相关性.我们进行了一个单中心，回顾性研究单心室CHD患者和曾接受Glenn姑息治疗的患者,在2011年至2020年的同一手术期间接受了心导管插入术和气泡超声心动图检查.进行Spearman的等级相关性以检查总的双侧分流和全身氧合测量之间的关系。以及单侧分流和同侧肺静脉氧合。对于所有患者（n=72），双侧总分流与外周血氧饱和度(SpO2)中度相关(rs=-0.44,p<0.0001).对于Glenn/Kawashima循环患者（n=49），总的双侧分流呈中度相关（SpO2：rs=-0.38，p<0.01）。相比之下,对于任何测量的静脉,单侧分流与同侧肺静脉氧合不相关(p=0.16-p>0.99).总之,双侧气泡分流的总负荷与全身氧合相关,可能更好地反映所有肺段的PAVM总负荷.单侧相关性可能会受到非标准化肺静脉采样方法的不利影响。
