Comparative accuracy of two-dimensional echocardiography and Doppler pressure half-time methods in assessing severity of mitral stenosis in patients with and without prior commissurotomy.
Comparative accuracy of two-dimensional echocardiography and Doppler pressure half-time methods in assessing severity of mitral stenosis in patients with and without prior commissurotomy.
复制标题
二维超声心动图和多普勒压力半时法在评估有或没有既往连合切开术的患者二尖瓣狭窄严重程度方面的比较准确性。
作者：
Mikel D. Smith;R. Handshoe;S. Handshoe;Ling Kwan;A. DeMaria
本研究的目的是比较二维超声心动图（2DE）和多普勒压力半时方法对单纯二尖瓣狭窄患者心导管测量二尖瓣面积无创评估的准确性，无论是否进行过合骨切开术。回顾性分析74例连续患者的资料，这些患者在30个月内接受了心导管插入术以评估二尖瓣狭窄，并在插入术前进行了二维超声心动图检查。6例患者（8.1%）在技术上存在2DE图像不足，他们的数据被排除在分析之外。其中2例患者接受了合骨切开术，其余4例未接受。我们对45例患者进行了连续波多普勒超声心动图检查，所有患者均获得了足够的半倍压测量值。二维超声心动图二尖瓣面积测量为短轴扫描时显示的最小二尖瓣孔内边缘的平面测量面积，而压力半时间计算为多普勒频谱信号包络测量的峰值透射速度与速度/平方根2之间的间隔。导管的计算代表了最小的静态瓣膜面积，由Gorlin公式导出，使用压力梯度和心输出量的热稀释测量。37例患者既往行二尖瓣合拢切开术（平均11.2 +/- 5.4年），其余37例患者既往未行手术。插管时测定的瓣膜平均面积为0.37 ~ 2.30 cm2（平均= 1.08 +/- 0.42 cm2）。（摘要删节250字）
This study was undertaken to compare the accuracies of the two-dimensional echocardiographic (2DE) and Doppler pressure half-time methods for the noninvasive estimation of cardiac catheterization measurements of mitral valve area in patients with pure mitral stenosis both with and without a previous commissurotomy. Data were retrospectively obtained from 74 consecutive patients who underwent cardiac catheterization within a 30 month period for evaluation of mitral stenosis, and who had two-dimensional echocardiograms performed before catheterization. Six patients (8.1%) had technically inadequate 2DE images and their data were excluded from analysis. Two of these patients had undergone commissurotomy, while the remaining four had not. Continuous-wave Doppler echocardiographic examinations were attempted in 45 patients and adequate measurements of pressure half-times were obtained in all patients studied. Mitral valve area by two-dimensional echocardiography was measured as the planimetered area along the inner border of the smallest mitral orifice visualized during short-axis scanning, while pressure half-time was calculated as the interval between the peak transmitral velocity and velocity/square root 2 as measured from the envelope of the Doppler spectral signal. Calculations from catheterization represented the minimal valve area at rest as derived from the Gorlin formula with the use of pressure gradients and thermodilution measurements of cardiac output. Thirty-seven of the patients had had a previous mitral commissurotomy a mean of 11.2 +/- 5.4 years before, while the remaining 37 patients were previously unoperated. Mean valve area as determined at catheterization for the total group of patients ranged from 0.37 to 2.30 cm2 (mean = 1.08 +/- 0.42 cm2).(ABSTRACT TRUNCATED AT 250 WORDS)