Echocardiographic assessment of aortic valve area in elderly patients with aortic stenosis and of changes in valve area after percutaneous balloon valvuloplasty.
Echocardiographic assessment of aortic valve area in elderly patients with aortic stenosis and of changes in valve area after percutaneous balloon valvuloplasty.
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超声心动图评估老年主动脉瓣狭窄患者的主动脉瓣面积以及经皮球囊瓣膜成形术后瓣膜面积的变化。
DOI：
10.1016/s0735-1097(87)80169-9
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发表时间：
1987
影响因子：
24
通讯作者：
R. Safian
中科院分区：
文献类型：
--
作者：
P. Come;M. Riley;R. McKay;R. Safian
在 31 名年龄 > 60 岁的患者中进行了超声心动图研究，这些研究足以使用连续性方程分析主动脉瓣面积，这些患者正在接受导管插入术以评估可疑的主动脉瓣狭窄。插管确定的主动脉瓣面积为 0.74 ± 0.30 cm2（平均值 ± SD），多普勒确定的主动脉瓣面积为 0.68 ± 0.27 和 0.65 ± 0.27 cm2，具体取决于是否将峰值速度或平均速度分别输入到连续性方程中。多普勒衍生和导管插入确定的主动脉瓣面积之间存在显着相关性（对于采用峰值速度的连续性方程和采用平均速度的连续性方程，r = 0.86，p < 0.001），Ftest 证明其呈线性（导管插入面积 = -0.03 + 1.13 × 使用峰值速度确定的多普勒面积，SEE = 0.163 cm2，p < 0.001；导管插入面积 = -0.02 + 1.16 × 使用平均速度确定的多普勒面积，SEE = 0.165 cm2，p < 0.001）。两组相关性均具有满足同一性条件的线性回归参数。主动脉瓣偏移、心室射血时间、二分之一颈动脉上冲时间、最大多普勒速度和最大多普勒梯度与导管插入主动脉瓣面积之间的无创测量值之间也存在显着的线性相关性，但这些相关性不如导管插入和多普勒连续性方程确定的瓣膜面积之间的相关性紧密。 10名患者接受了经皮球囊主动脉瓣成形术。在瓣膜成形术之前（r = 0.77，p = 0.01；p < 0.001 by Ftest，SEE = 0.134 cm2）和瓣膜成形术之后（r = 0.85，p < 0.01；p = 0.0001 by Ftest，SEE = 0.161），通过多普勒和导管插入方法确定的主动脉瓣面积之间存在显着的线性相关性。厘米2）。线性回归参数满足同一性条件。导管插入术和多普勒测量主动脉瓣面积绝对变化之间也存在显着的线性相关性（r = 0.79，p < 0.01；通过Ftest，p < 0.001，SEE = 0.11 cm2）。老年患者的主动脉瓣面积可以通过连续性方程可靠地确定。此外，球囊瓣膜成形术的结果（通过导管插入确定的主动脉瓣面积的变化来测量）可以通过使用连续性方程确定的主动脉瓣面积的变化来准确反映。
Echocardiographic studies, adequate for analysis of aortic valve area using the continuity equation, were obtained in 31 patients aged >60 years who were undergoing catheterization for assessment of suspected aortic stenosis. Catheterization-determined aortic valve area was 0.74 ± 0.30 cm2(mean ± SD) and Doppler-deter-mined aortic valve areas were 0.68 ± 0.27 and 0.65 ± 0.27 cm2, depending on whether peak or mean velocities, respectively, were entered into the continuity equation. There were significant correlations between both of the Doppler-derived and the catheterization-determined aortic valve areas (r = 0.86, p < 0.001 for both the continuity equation employing peak velocities and the continuity equation employing mean velocities) which were demonstrated to be linear byFtest (catheterization area = −0.03 + 1.13 × Doppler area determined using peak velocities, SEE = 0.163 cm2, p < 0.001; and catheterization area = −0.02 + 1.16 × Doppler area determined using mean velocities, SEE = 0.165 cm2, p < 0.001). Both sets of correlations had linear regression parameters meeting the conditions for identity. Significant linear correlations were also noted between the noninvasive measurements of aortic valve excursion, ventricular ejection time, time to one-half carotid upstroke, maximal Doppler velocity and maximal Doppler gradient and catheterization aortic valve area, but the correlations were less tight than those between valve areas determined by catheterization and by Doppler continuity equation.Ten of the patients underwent percutaneous balloon aortic valvuloplasty. There were significant linear correlations between aortic valve areas determined by Doppler and catheterization methods both before valvuloplasty (r = 0.77, p = 0.01; p < 0.001 byFtest, SEE = 0.134 cm2) and after valvuloplasty (r = 0.85, p < 0.01; p = 0.0001 byFtest, SEE = 0.161 cm2). Linear regression parameters met the conditions for identity. There was also a significant linear correlation between catheterization and Doppler measurements of absolute change in aortic valve area (r = 0.79, p < 0.01; p < 0.001 byFtest, SEE = 0.11 cm2).Aortic valve area can be determined reliably by continuity equation in elderly patients. In addition, results of balloon valvuloplasty, measured by changes in catheterization-determined aortic valve area, are accurately reflected by changes in aortic valve area determined using the continuity equation.