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成人主动脉瓣狭窄中超声心动图与心音图的比较。55例病例

[Comparison of echocardiography and phonomecanography in adult aortic valve stenosis. 55 cases].

作者信息

Lesbre J P, Bernasconi P, Duboisset M, Quiret J C, Rey J L, Kalisa A, Schurtz C, Eloy J P

出版信息

Arch Mal Coeur Vaiss. 1978 Dec;71(12):1356-64.

PMID:106789
Abstract

The results of echocardiography and phonomecanography were compared in 55 cases of adult valvular aortic stenosis. Although the most reliable echocardiographic sign of the severity of stenosis is the systolic separation of the aortic valve echos, it should be amphasised that: -- this cannot be measured in 25 % cases; --in 10 % cases the values obtained vary with the angle of the transducer. In these cases, the finding of a left ventricular posterior wall thickness greater than or equal to 15 mm is specific for severe aortic stenosis. On the other hand, the left atrial, left ventricular and aortic internal dimensions and the morphology of the mitral leaflets do not help in the estimation of the severity of adult aortic stenosis. The best correlations between echo and phonocardiography are the values of aortic valve opening and : --hemi-ascension time (r = 0.67); --left ventricular ejectiontime (r = 0.93) when patients in cardiac failure are excluded. The complementary nature of these two investigations is notable, and should, in pure aortic stenosis without angina, spare patients who are often elderly and fragile from heamodynamic investigation.

摘要

对55例成人主动脉瓣狭窄患者的超声心动图和心音图检查结果进行了比较。虽然狭窄严重程度最可靠的超声心动图征象是主动脉瓣回声的收缩期分离,但应强调:——25%的病例无法测量这一指标;——10%的病例所测得的值会因换能器角度而变化。在这些病例中,左心室后壁厚度大于或等于15mm对重度主动脉瓣狭窄具有特异性。另一方面,左心房、左心室和主动脉内径以及二尖瓣叶形态无助于评估成人主动脉瓣狭窄的严重程度。超声心动图与心音图之间最佳的相关性是主动脉瓣开放值与:——半上升时间(r = 0.67);——排除心力衰竭患者时的左心室射血时间(r = 0.93)。这两项检查的互补性很显著,对于无心绞痛的单纯主动脉瓣狭窄患者,应避免对通常年老体弱的患者进行血流动力学检查。

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