DOPPLER ECHOCARDIOGRAPHIC MEASUREMENT OF AORTIC-VALVE AREA IN AORTIC-STENOSIS - A NONINVASIVE APPLICATION OF THE GORLIN FORMULA
DOPPLER ECHOCARDIOGRAPHIC MEASUREMENT OF AORTIC-VALVE AREA IN AORTIC-STENOSIS - A NONINVASIVE APPLICATION OF THE GORLIN FORMULA
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DOI：
10.1016/s0735-1097(86)80382-5
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发表时间：
1986-11-01
影响因子：
24
通讯作者：
POPP, RL
中科院分区：
文献类型：
--
作者：
TEIRSTEIN, P;YEAGER, M;POPP, RL
30例成人主动脉瓣狭窄患者在心导管插入术后1天内进行了多普勒超声心动图检查。通过将简化的Bernoulli方程应用于连续波多普勒跨主动脉速度记录，计算平均跨主动脉压差的无创测量。通过将左心室流出道的收缩期流速积分（通过脉冲多普勒超声检查获得）乘以左心室流出道的横截面积（通过二维超声心动图测量），无创测量每搏输出量。采用两种方法计算主动脉瓣面积。在方法1中，使用多普勒导出的平均压差、心输出量和收缩期射血周期应用Gorlin方程。方法2使用连续性方程。这些非侵入性的测量结果进行了比较，有创测量使用线性回归分析，平均压力梯度相关性良好（r = 0.92）。两种无创方法的主动脉瓣面积与心导管检查值也有良好的相关性（方法1，r = 0.87;方法2，r = 0.88）。多普勒超声检测主动脉瓣重度狭窄的敏感性为0.86，特异性为0.88，阳性预测值为0.86。非同时测量的心输出量显示相关性较差（r = 0.51）。多普勒超声心动图可以区分临界和非临界主动脉瓣狭窄，具有高度的准确性。主动脉瓣面积的测量有助于在梯度处于中间范围（30至50 mm Hg）时解释多普勒导出的平均压差数据。
Thirty adult patients with aortic stenosis had Doppler echocardiography within 1 day of cardiac catheterization. Noninvasive measurement of the mean transaortic pressure gradient was calculated by applying the simplified Bernoulli equation to the continuous wave Doppler transaortic velocity recording. Stroke volume was measured noninvasively by multiplying the systolic velocity integral of flow in the left ventricular outflow tract (obtained by pulsed Doppler ultrasonography) by the cross-sectional area of the left ventricular outflow tract (measured by two-dimensional echocardiography). Noninvasive measurement of aortic valve area was calculated by two methods. In method 1, the Gorlin equation was applied using Doppler-derived mean pressure gradient, cardiac output and systolic ejection period. Method 2 used the continuity equation. These noninvasive measurements were compared with invasive measurements using linear regression analysis, and mean pressure gradients correlated well (r = 0.92). Aortic valve area by either noninvasive method also correlated well with cardiac catheterization values (method 1, r = 0.87; method 2, r = 0.88). The sensitivity of Doppler detection of critical aortic stenosis was 0.86, with a specificity of 0.88 and a positive predictive value of 0.86. Cardiac output measured nonsimultaneously showed poor correlation (r = 0.51). Doppler echocardiography can distinguish critical from noncritical aortic stenosis with a high degree of accuracy. Measurement of aortic valve area aids interpretation of Doppler-derived mean pressure gradient data when the gradients are in a intermediate range (30 to 50 mm Hg).