Prediction of gradients in fibrous subaortic stenosis by continuous wave two-dimensional Doppler echocardiography: animal studies.
Prediction of gradients in fibrous subaortic stenosis by continuous wave two-dimensional Doppler echocardiography: animal studies.
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通过连续波二维多普勒超声心动图预测纤维主动脉瓣下狭窄的梯度：动物研究。
DOI：
10.1016/s0735-1097(85)80349-1
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发表时间：
1985
影响因子：
24
通讯作者：
J. Pierce
中科院分区：
文献类型：
--
作者：
L. Valdes‐Cruz;M. Jones;S. Scagnelli;D. Sahn;F. Tomizuka;J. Pierce
本研究的目的是评估连续波二维多普勒超声心动图预测离散主动脉瓣下狭窄处压力梯度的准确性。对23只主动脉瓣下狭窄的纽芬兰犬进行了研究，通过闭胸多普勒询问左心室流出道心尖部的主动脉速度，同时在心导管插入术中测量压力梯度。连续模式多普勒询问与二维回波描记引导（Irex型号IIIB），比较多普勒导出的最大速度与压力梯度在休息时和激发后的阻塞与亚硝酸戊酯吸入和异丙肾上腺素输注。多普勒记录的最大流速范围为98 ~ 539 cm/s，与血流动力学梯度范围为3 ~ 123 mm Hg相关（r = 0.92，SEE = 37 cm/s）。多普勒速度转换为梯度使用简化的伯努利关系（梯度= 4 ×最大速度2）;由此产生的多普勒衍生梯度也与导管插入术测量的压力梯度密切相关（r = 0.95，SEE = 7.1 mm Hg）。多普勒超声心动图估计跨二尖瓣压力梯度的预测能力，证实了这组狗的主动脉下肌肉阻塞，其疾病谱与在人类中发现的相似。结果还表明，多普勒方法可能在主动脉瓣下狭窄患者的临床应用。
The purpose of this study was to assess the accuracy of continuous wave, two-dimensional Doppler echocardiography for predicting pressure gradients across discrete subaortic stenoses. Twenty-three Newfoundland dogs with subaortic stenosis were studied by closed chest Doppler interrogation of aortic velocity from an apical view of the left ventricular outflow tract simultaneously with measurements of pressure gradient during cardiac catheterization. Continuous mode Doppler interrogation was used with two-dimensional echographic guidance (Irex model IllB) to compare the Doppler-derived maximal velocity with the pressure gradient across the obstruction at rest and after provocation with amyl nitrite inhalation and isoproterenol infusion. The maximal velocities recorded by Doppler ranged from 98 to 539 cm/s and correlated with hemodynamic gradients ranging from 3 to 123 mm Hg (r = 0.92, SEE = 37 cm/s). Doppler velocities were converted to gradients using a simplification of the Bernoulli relation (gradient = 4 × maximal velocity2); the resulting Doppler-derived gradients also correlated closely with the catheterization-measured pressure gradients (r = 0.95, SEE = 7.1 mm Hg).The predictive capability of Doppler echocardiography for estimating the pressure gradient across fibro-muscular subaortic obstructions in this group of dogs with a spectrum of disease similar to that found in human beings was validated. The results also indicate that Doppler methods may have clinical applications in patients with subaortic stenosis.