Tissue Doppler imaging in patients with moderate to severe aortic valve stenosis: Clinical usefulness and diagnostic accuracy
Tissue Doppler imaging in patients with moderate to severe aortic valve stenosis: Clinical usefulness and diagnostic accuracy
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DOI：
10.1016/j.ahj.2004.03.049
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发表时间：
2004-10-01
影响因子：
4.8
通讯作者：
Wichter, T
中科院分区：
文献类型：
--
作者：
Bruch, C;Stypmann, J;Wichter, T
背景：组织多普勒成像（TDI）获得的二尖瓣环速度提供了有关左心室（LV）长轴功能的信息，并允许在选定的患者亚组中评估LV充盈压。本研究旨在评价TDI在中重度主动脉瓣狭窄（AS）患者中的应用价值。（平均主动脉瓣面积0.8 +/- 0.4 cm（2）），其中排除了冠状动脉疾病，36名年龄匹配的无症状对照受试者接受了射血分数，缩短分数，和二尖瓣流入（E、A、E/A比值）。TDI速度（S '，F，A'）来自间隔二尖瓣环。在AS患者中，心房收缩前的LV压力结果与对照组相比，AS患者二尖瓣环收缩期（S '）和舒张早期（F）速度明显降低（收缩期5.5 ± 1.2cm/s vs 8.3 ± 1.3cm/s;舒张早期5.6 ± 1.6 vs 10.2 ± 3.0 cm/s，P 15 mm Hg，敏感性为93%，特异性为88%。在这些患者中，即使射血分数和心脏指数正常，收缩长轴功能也会受损。因此，TDI整合了收缩和舒张性能的信息，可能是一个有用的补充，超声心动图检查和护理的AS患者。
Background Mitral annular velocities derived from tissue Doppler imaging (TDI) provide information about left ventricular (LV) long-axis function and allow for the assessment of LV filling pressures in selected subsets of patients. It was the aim of this study to assess the usefulness of TDI in patients with moderate to severe aortic valve stenosis (AS).Methods Twenty-three patients with moderate to severe AS (mean aortic valve area 0.8 +/- 0.4 cm(2)), in whom coronary artery disease had been ruled out, and 36 asymptomatic age-matched control subjects underwent assessment of ejection fraction, fractional shortening, and mitral inflow (E, A, E/A ratio). TDI velocities (S', F, A') were derived from the septal mitral annulus. In patients with AS, LV pressure before atrial contraction (LV pre-A pressure), LV,end-diastolic pressure, and cardiac index were measured during cardiac catheterization.Results In patients with AS, systolic (S') and early diastolic mitral annular velocities (F) were significantly reduced in comparison to control subjects (systolic, 5.5 +/- 1.2 vs 8.3 +/- 1.3 cm/s; early diastolic, 5.6 +/- 1.6 vs 10.2 +/- 3.0 cm/s, P 15 mm Hg, with a sensitivity of 93% and a specificity of 88%.Conclusions, in patients with moderate to severe AS, TDI allows for a reliable, noninvasive estimation of filling pressures. In such patients, systolic long-axis function is impaired even in the presence of normal ejection fraction and cardiac index. Thus, TDI integrates information about systolic and diastolic performance and may be a useful addition in the echocardiographic workup and care of patients with AS.