Application of the proximal flow convergence method to calculate the effective regurgitant orifice area in aortic regurgitation
Application of the proximal flow convergence method to calculate the effective regurgitant orifice area in aortic regurgitation
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DOI：
10.1016/s0735-1097(98)00356-8
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发表时间：
1998-10-01
影响因子：
24
通讯作者：
Tajik, AJ
中科院分区：
文献类型：
--
作者：
Tribouilloy, CM;Enriquez-Sarano, M;Tajik, AJ
目标.目的探讨近端等速表面积（比萨）法计算主动脉瓣反流（AR）有效返流口（ERO）的可靠性。ERO面积可通过比萨方法计算，但该方法尚未在AR. Methods中得到验证。采用比萨法对71例连续患者进行了前瞻性ERO计算，其中64例为孤立性AR，并与两种同步参考方法（定量多普勒和定量二维超声心动图）进行了比较。此外，还将该方法与12例患者的血管造影、18例患者的手术评估以及所有患者的心室容积进行了比较。比萨和参考方法之间具有良好的相关性（均r = 0.90，均p < 0.0001），但注意到比萨方法有低估ERO的趋势（分别为24 +/- 19 vs. 26 +/- 22 mm（2）和27 +/- 23 mm（2），均p = 0.04）。然而，这一趋势仅限于5例血流会聚角变钝（>220度）的患者，在多变量分析中，该变量是低估ERO的唯一独立决定因素。与此相反，在59例患者中，（小于或等于220度），与参考方法相比，比萨方法显示出良好的相关性，估计值的标准误差很窄（r = 0.95，见5.4 mm（2）和r = 0.95，见5.8 mm（2）;所有p < 0.0001）并且没有低估的趋势（22 +/- 18 vs. 23 +/- 16 mm（2），p = 0.44，vs. 23 +/- 18 mm（2），p = 0.34）。在AR患者中，比萨方法可用于测量ERO，具有合理的可行性。比萨对ERO的低估可能发生在具有钝角血流会聚角的患者中。然而，在大多数具有适当血流会聚的患者中，比萨提供了AR的ERO的可靠测量。(C)1998年，美国心脏病学会。
Objectives. We sought to determine the reliability of the proximal isovelocity surface area (PISA) method for calculation of effective regurgitant orifice (ERO) of aortic regurgitation (AR).Background. The ERO area can be calculated by the PISA method, but this method has not been validated in AR.Methods. ERO calculation by the PISA method was undertaken prospectively in 71 consecutive patients,vith isolated AR and achieved in 64 and compared with two simultaneous reference methods (quantitative Doppler and quantitative two-dimensional echocardiography). In addition, this method was compared with angiography in 12 patients, with surgical assessment in 18 patients and with ventricular volumes in all patients.Results. Good correlations between PISA and reference methods were obtained (both r = 0.90, both p < 0.0001), but a trend toward underestimation of the ERO by the PISA method was noted (24 +/- 19 vs. 26 +/- 22 mm(2) and 27 +/- 23 mm(2), respectively, both p = 0.04). However, this trend was confined to five patients with an obtuse flow convergence angle (>220 degrees), and on multivariate analysis this variable was the only independent determinant of underestimation of the ERO. In contrast, in 59 patients with a flat flow convergence (less than or equal to 220 degrees), the PISA method, in comparison with reference methods, showed excellent correlations, with a narrow standard error of the estimate (r = 0.95, SEE 5.4 mm(2), and r = 0.95, SEE 5.8 mm(2); all p < 0.0001) and no trend toward underestimation (22 +/- 18 vs. 23 +/- 16 mm(2), p = 0.44, and vs. 23 +/- 18 mm(2), p = 0.34).Conclusions. In patients with AR, the PISA method can be used to measure the ERO with reasonable feasibility. Underestimation of the ERO by PISA may occur in patients with an obtuse flow convergence angle. However, in most patients with appropriate flow convergence, PISA provides reliable measurement of the ERO of AR. (C) 1998 by the American College of Cardiology.