ACCURATE NONINVASIVE QUANTIFICATION OF STENOTIC AORTIC-VALVE AREA BY DOPPLER ECHOCARDIOGRAPHY
ACCURATE NONINVASIVE QUANTIFICATION OF STENOTIC AORTIC-VALVE AREA BY DOPPLER ECHOCARDIOGRAPHY
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DOI：
10.1161/01.cir.73.3.452
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发表时间：
1986-03-01
期刊：
影响因子：
37.8
通讯作者：
QUINONES, MA
中科院分区：
文献类型：
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作者：
ZOGHBI, WA;FARMER, KL;QUINONES, MA
通过管道的层流等于平均速度乘以孔的横截面积。因此，体积等于时间-速度积分乘以横截面积。在主动脉瓣狭窄中，狭窄射流中的流动是层流，主动脉瓣面积应等于通过瓣膜喷射的血液体积除以连续波多普勒超声心动图记录的主动脉射流速度的时间-速度积分。为了测试这一概念是否可以用于准确地确定主动脉瓣面积无创多普勒方法，39例患者（年龄35至82岁，平均63）进行了脉冲多普勒结合二维超声心动图测量每搏输出量在主动脉瓣，肺动脉瓣，二尖瓣环以及连续波多普勒记录主动脉瓣射流。在心导管插入术中通过Gorlin方程确定的主动脉瓣面积范围在0.4和2.07 cm 2之间（平均0.89 ± 0.05 cm 2）。0.45）。多普勒衍生的瓣膜面积，由主动脉瓣环、肺动脉瓣环或二尖瓣环的每搏输出量值确定，与心导管检查确定的面积相关性良好（r分别为0.95、0.97和0.96）。一种测量主动脉瓣面积的简化方法，即主动脉瓣环的横截面积乘以主动脉瓣近端的峰值速度除以峰值主动脉射流速度，与心导管检查获得的测量结果相关性良好（r= .94）。使用任一种多普勒方法均可观察到临界和非临界主动脉瓣狭窄之间的良好分离。因此，组合脉冲和连续波多普勒可用于准确测量成人主动脉瓣狭窄患者的瓣膜面积。
Laminar flow through a conduit is equal to the mean velocity times the cross-sectional area of the orifice. Therefore, volume is equal to the time-velocity integral multiplied by the cross-sectional area. In aortic stenosis, flow in the stenotic jet is laminar and the aortic value area should be equal to the volume of blood ejected through the valve divided by the time-velocity integral of the aortic jet velocity recorded by continuous-wave Doppler echocardiography. To test whether this concept can be used to accurately determine aortic valve area noninvasively by the Doppler method, 39 patients (age 35 to 82 years, mean 63) underwent pulsed Doppler combined with two-dimensional echocardiography for measurement of stroke volume at the aortic, pulmonic, and mitral anulus as well as continous-wave Doppler recording of the aortic jet. Aortic valve area determined at cardiac catheterization by the Gorlin equation ranged between 0.4 and 2.07 cm2 (mean 0.89 .+-. 0.45). Doppler-derived valve area, determined with the stroke volume value from either the aortic, pulmonic, or mitral anulus, correlated well with the area determined at cardiac catheterization (r= .95, .97, and .96, respectively). A simplified method for measuring aortic valve area derived as the cross-sectional area of the aortic anulus times peak velocity just proximal to the aortic valve divided by peak aortic jet velocity correlated well with measurements obtained at cardiac catheterization (r= .94). An excellent separation between critical and noncritical aortic stenosis was seen using either one of the Doppler methods. Thus, combined pulsed and continuous-wave Doppler can be used to accurately measure valve area in adult patients with aortic stenosis.