DOPPLER ECHOCARDIOGRAPHIC FINDINGS IN ADULTS WITH SEVERE SYMPTOMATIC VALVULAR AORTIC-STENOSIS
DOPPLER ECHOCARDIOGRAPHIC FINDINGS IN ADULTS WITH SEVERE SYMPTOMATIC VALVULAR AORTIC-STENOSIS
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DOI：
10.1016/0002-9149(91)90282-p
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发表时间：
1991-12-01
影响因子：
2.8
通讯作者：
BASHORE, TM
中科院分区：
文献类型：
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作者：
OTTO, CM;NISHIMURA, RA;BASHORE, TM
分析了24家医疗中心接受球囊主动脉瓣成形术的680例成人（平均年龄78岁）的基线超声心动图数据，以描述症状性主动脉瓣狭窄患者的流出道梗阻程度。 最大主动脉射流速度范围为2.3 - 6.6 m/s（平均4.4 +/- 0.8），连续性方程瓣膜面积范围为0.1 - 1.4 cm 2（平均0.6 +/- 0.2）。 值得注意的是，36%的患者的射流速度小于或等于4.0 m/s，但只有3%的患者的瓣膜面积> 1.0 cm 2，因为收缩功能受损的患病率很高（54%）。 流出道直径与体表面积相关性较差（p = 0.26），尽管女性的组平均直径小于男性（1.9 +/- 0.2 vs 2.1 +/- 0.3 cm，p = 0.0001）。平均压差与最大压差（r = 0.92）和最大喷射速度（平均DELTA-P = 2.4 V2 + 0.75 mm Hg）密切相关。 主动脉瓣狭窄严重程度的简单测量与多普勒和侵入性瓣膜面积相关，如下所示：最大射流速度（r = -0.36和-0.32），平均梯度（r = -0.33和-0.29），流出道与射流速度比（r = 0.67和0.40）和缩短速度比分数（r = 0.29和0.22）。这项研究表明，在有症状的成人中，接受球囊主动脉瓣成形术的狭窄严重程度存在显著差异。 流出道直径和身体尺寸之间缺乏可预测的关系，这强调了如果需要定义瓣膜面积，则在每个患者中进行该测量的重要性。 平均压差和最大射流速度之间的相关性，以及瓣膜面积和流速比之间的相关性支持这些更简单的狭窄严重程度测量的潜在用途。
Baseline echocardiographic data in 680 adults (mean age 78 years) undergoing balloon aortic valvuloplasty at 24 medical centers were analyzed to describe the degree of outflow obstruction in patients with symptomatic aortic stenosis. Maximal aortic jet velocity ranged from 2.3 to 6.6 m/s (mean 4.4 +/- 0.8) and continuity equation valve area ranged from 0.1 to 1.4 cm2 (mean 0.6 +/- 0.2). Of note, 36% had a jet velocity less-than-or-equal-to 4.0 m/s but only 3% had a valve area > 1.0 cm2 due to a high prevalence of impaired systolic function (54%). Outflow tract diameter was poorly correlated with body surface area (p = 0.26), although the group mean diameter was smaller in women than in men (1.9 +/- 0.2 vs 2.1 +/- 0.3 cm, p = 0.0001).Mean pressure gradient was related closely to maximal gradient (r = 0.92) and to maximal jet velocity (mean DELTA-P = 2.4 V2 + 0.75 mm Hg). Simpler measures of aortic stenosis severity were correlated with Doppler and invasive valve area as follows: maximal jet velocity (r = -0.36 and -0.32), mean gradient (r = -0.33 and -0.29), outflow tract to jet velocity ratio (r = 0.67 and 0.40), and the fractional shortening velocity ratio (r = 0.29 and 0.22).This study demonstrates marked variability in stenosis severity in symptomatic adults referred for balloon aortic valvuloplasty. The absence of a predictable relation between outflow tract diameter and body size emphasizes the importance of this measurement in each patient if definition of valve area is needed. The correlations between mean pressure gradient and maximal jet velocity, and between valve area and the velocity ratio support the potential use of these simpler measures of stenosis severity.