Clinical evaluation versus Doppler echocardiography in the quantitative assessment of valvular heart disease.
Clinical evaluation versus Doppler echocardiography in the quantitative assessment of valvular heart disease.
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瓣膜性心脏病定量评估中的临床评估与多普勒超声心动图的比较。
DOI：
10.1161/01.cir.78.2.267
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发表时间：
1988
期刊：
影响因子：
37.8
通讯作者：
Greene,ER
中科院分区：
文献类型：
--
作者：
Jaffe,WM;Roche,AH;Coverdale,HA;McAlister,HF;Ormiston,JA;Greene,ER
我们验证了这样的假设，即多普勒超声心动图在检测重大的主动脉瓣和二尖瓣病变方面比临床评估具有更高的准确性，并且与心导管检查相比，多普勒超声心动图在评估瓣膜疾病严重程度方面具有很高的准确性。因此，在选定的患者中，可能没有必要通过心导管检查来评估瓣膜病变的严重程度。我们前瞻性地评估了连续75名临床怀疑心脏瓣膜病的患者，年龄20-74岁(平均52岁)。使用特定的临床和多普勒超声心动图标准将每个瓣膜病变分类为无、不显著或显著。心导管术中病变严重的标准是动脉或二尖瓣面积分别小于1.1或1.5cm2，或等于或大于3+cm2血管造影时的主动脉或二尖瓣返流。在所有瓣膜病变中，多普勒超声心动图的总体准确性高于临床评估。二尖瓣狭窄、主动脉瓣狭窄、主动脉瓣返流和二尖瓣返流的准确率分别提高了28%、19%、15%和7%，总体准确率分别为97%、100%、95%和96%。仅临床评估就犯了28个错误(37%的患者和19%的瓣膜病变评估)，其中17个错误(23%的患者和12%的瓣膜病变)会导致不适当的处理。在这17名患者中，只有4名(24%)的主治医生不会在插管时对瓣膜进行评估。
We tested the hypotheses that Doppler echocardiography has a higher accuracy than clinical evaluation in the detection of significant aortic and mitral valvular heart disease and that Doppler echocardiography is highly accurate as compared with cardiac catheterization for the assessment of valvular disease severity. Thus, cardiac catheterization for the assessment of valve lesion severity may be unnecessary in selected patients. We prospectively evaluated 75 consecutive patients, ages 20-74 years (mean, 52 years), with clinically suspected valvular heart disease. Specific clinical and Doppler echocardiographic criteria were used to categorize each valve lesion as absent, insignificant, or significant. Criteria for a significant lesion at cardiac catheterization was an aortic or mitral valve area less than 1.1 or 1.5 cm2, respectively, or equal to or greater than 3+ cm2 aortic or mitral regurgitation at angiography. In all valve lesions, Doppler echocardiography had a higher overall accuracy than clinical evaluation. Increases in accuracies of 28%, 19%, 15%, and 7% occurred for mitral stenosis, aortic stenosis, aortic regurgitation, and mitral regurgitation, respectively, resulting in overall accuracies of 97%, 100%, 95%, and 96%. Clinical evaluation alone made 28 errors (37% of patients and 19% of valve lesions assessed), and 17 of these errors (23% of patients and 12% of valve lesions) would have resulted in inappropriate management. In only four (24%) of these 17 patients, the attending cardiologist would not have proceeded to assess the valve at cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
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不再对瓣膜性心脏病进行常规导管插入术？
DOI：
10.1056/nejm198111193052109
发表时间：
1981
期刊：
The New England journal of medicine
影响因子：
--
作者：
R. O. Brandenburg
通讯作者：
R. O. Brandenburg
影响因子：
4.8
作者：
GRAETTINGER, WF;GREENE, ER;VOYLES, WF
通讯作者：
VOYLES, WF
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。
影响因子：
37.8
作者：
Mikel D. Smith;R. Handshoe;S. Handshoe;Ling Kwan;A. DeMaria
通讯作者：
A. DeMaria
实时二维多普勒超声心动图血流图。
影响因子：
37.8
作者：
D. Sahn
通讯作者：
D. Sahn
单独通过多普勒超声技术评估心输出量。
影响因子：
--
作者：
N. Haites;F. McLennan;D. H. Mowat;J. Rawles
通讯作者：
J. Rawles