Detection of mild aortic regurgitation by range-gated pulsed Doppler echocardiograhy.
Detection of mild aortic regurgitation by range-gated pulsed Doppler echocardiograhy.
复制标题
通过距离选通脉冲多普勒超声心动图检测轻度主动脉瓣反流。
DOI：
10.1016/0002-9149(82)90414-3
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
R. Esper
中科院分区：
文献类型：
--
作者：
R. Esper
为了评价距离选通脉冲多普勒超声心动图检测主动脉瓣关闭不全的敏感性和特异性，对46例患者进行了这项技术的研究。将受试者分为3组：I组19例，均患有各种心脏疾病，但主动脉瓣功能正常。心导管检查显示19例患者中无一例主动脉瓣返流，多普勒超声心动图未发现左室流出道舒张期血流紊乱。II组17例，均经临床和听诊证实为主动脉瓣关闭不全，其中6例经心导管检查证实为主动脉瓣关闭不全。超声心动图显示左室流出道有不同程度的舒张期湍流血流与主动脉瓣关闭不全相容。第三组为10例无临床或听诊证据的主动脉瓣关闭不全患者。超声心动图仅检出1例二尖瓣扑动。心导管检查显示主动脉瓣返流1~4级者9例，未插管者6个月后出现主动脉瓣关闭不全杂音。在所有10例患者中，多普勒超声心动图在左室流出道检测到与主动脉瓣返流相容的返流湍流。结论：多普勒超声心动图较听诊和超声心动图对轻度主动脉瓣关闭不全的诊断更有价值。在这项研究中，距离选通脉冲多普勒超声心动图被证明是100%的敏感性和特异性。然而，为了评估其在更复杂的情况下(肥胖、肺气肿和心力衰竭)的有效性以及与其他舒张期杂音的鉴别诊断，有必要对更大范围的群体进行研究。
In order to assess the sensitivity and specificity of the range-gated pulsed Doppler echocardiogram for the detection of aortic regurgitation, a study with use of this technique was carried out in 46 patients. They were classified into 3 groups: Group I was composed of 19 patients with a variety of heart diseases but with a competent aortic valve. Cardiac catheterization revealed no aortic regurgitation in any of the 19 patients, and the Doppler echocardiogram detected no turbulent diastolic flow in the left ventricular outflow tract. Group II was composed of 17 patients who clinically and by auscultation had aortic regurgitation, which was confirmed by cardiac catheterization in 6. In all 17 patients the Doppler echocardiogram detected several grades of turbulent diastolic flow compatible with aortic regurgitation in the left ventricular outflow tract. Group III was composed of 10 patients with aortic regurgitation but without the expected clinical or auscultatory evidence. The echocardiogram detected mitral valve flutter in only 1 patient. Cardiac catheterization revealed aortic regurgitation graded 1 4 and 2 4 in 9 patients, and the patient who did not undergo catheterization had a murmur of aortic insufficiency 6 months later. In all 10 patients the Doppler echocardiogram detected a regurgitating turbulent flow compatible with aortic regurgitation in the left ventricular outflow tract. It is concluded that the Doppler echocardiogram was more useful than auscultation and echocardiography for the detection of mild aortic regurgitation. In this study the range-gated pulsed Doppler echocardiogram proved 100% sensitive and specific. However, it will be necessary to study larger groups in order to assess its utility in more complicated conditions (obesity, emphysema, and heart failure) and the differential diagnosis with other diastolic murmurs.