Coll G E, Shah P K, Siegel R J
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048-0750.
J Invasive Cardiol. 1990 Sep-Oct;2(5):193-8.
The purpose of this study was to assess whether the degree of fluoroscopic aortic valve calcification could help identify the presence of aortic stenosis in the elderly. To evaluate the diagnostic utility of cardiac fluoroscopy for the detection of aortic stenosis (aortic valve area less than or equal to 1.0 cm 2) in patients 60 years or older, aortic valve area determined by cardiac catheterization was related to the pattern of calcification seen on cinefluoroscopy in 97 patients (mean age of 72 +/- 6 years) with suspected aortic stenosis. Dense circumferential (3+) calcification of the aortic valve was seen on cinefluoroscopy in 56 of 59 patients with an aortic valve area less than or equal to 1.0 cm 2 (sensitivity 95%), compared to 5 of 38 patients with aortic valve area greater than 1.0 cm2 (specificity 87%) (p less than .001). These findings suggest that in patients 60 years of age or older with suspected aortic stenosis, a dense circumferential (3+) aortic valve calcification on cinefluoroscopy is highly predictive of an aortic valve area less than or equal to 1.0 cm2 with a positive predictive accuracy of 91% and a negative predictive accuracy of 91%. Thus cinefluoroscopy may provide an accurate adjunct or alternative to Doppler echocardiography in the assessment of aortic stenosis in the elderly.
本研究的目的是评估荧光透视下主动脉瓣钙化程度是否有助于识别老年人主动脉狭窄的存在。为评估心脏荧光透视对60岁及以上患者主动脉狭窄（主动脉瓣面积小于或等于1.0平方厘米）的诊断效用，在97例（平均年龄72±6岁）疑似主动脉狭窄患者中，将通过心导管检查确定的主动脉瓣面积与电影荧光透视所见的钙化模式相关联。在59例主动脉瓣面积小于或等于1.0平方厘米的患者中，有56例在电影荧光透视下可见主动脉瓣致密环形（3+）钙化（敏感性95%），相比之下，在38例主动脉瓣面积大于1.0平方厘米的患者中有5例出现这种情况（特异性87%）（p<0.001）。这些发现表明，在60岁及以上疑似主动脉狭窄的患者中，电影荧光透视下主动脉瓣致密环形（3+）钙化高度预示主动脉瓣面积小于或等于1.0平方厘米，阳性预测准确率为91%，阴性预测准确率为91%。因此，在评估老年人主动脉狭窄方面，电影荧光透视可能是多普勒超声心动图的一种准确辅助手段或替代方法。
