Arquès S, Sbragia P, Avran A, Dieuzaide P, Aviérinos J F, Ferracci A, Habib G, Luccioni R
Service de cardiologie B, centre hospitalier universitaire la Timone, boulevard Jean-Moulin, 13385 Marseille Cedex 05.
Arch Mal Coeur Vaiss. 2001 Feb;94(2):110-6.
The study of the convergence zone by echocardiography is a validated method of quantification of native valve mitral regurgitation. However, there is little data concerning its applications to paraprosthetic mitral regurgitation. The aim of this study was to evaluate the method in this indication. Thirty consecutive patients (21 mechanical and 9 bioprostheses) with paraprosthetic mitral regurgitation quantified by transoesophageal echocardiography were included: 4 mild, 13 moderate and 13 severe. The regurgitant volume RV) and the regurgitant surface area (RSA) were calculated by the following formulae: RV = 2 pi.r2.Va.t.alpha/180 and RSA = RV/VTI (r: mid systolic radius of the convergence zone, Va: aliasing velocity, t: regurgitation time, alpha/180: the angular correction due to parietal stress, VTI: velocity time integral of the regurgitant flow). The feasibility of the calculation of the RV and RSA was 93 and 63% respectively. There was a statistically significant correlation between the RV and transoesophageal echocardiography (r: 0.85, p < 0.001), between RSA and transoesophageal echocardiography (r: 0.67, p < 0.05) and between RV and RSA (r: 0.95, p < 0.001). When severe paraprosthetic regurgitation was defined by a RV greater than 60 ml and RSA greater than 40 mm2, the concordance between RV, RSA and transoesophageal echocardiography was 75% and 74% respectively. Therefore, the study of the convergence zone provides an accurate evaluation of paraprosthetic mitral regurgitation by transthoracic echocardiography.
通过超声心动图研究汇聚区是一种用于量化原发性二尖瓣反流的有效方法。然而，关于其在人工二尖瓣反流中的应用数据很少。本研究的目的是评估该方法在这一适应症中的应用。纳入了30例经食管超声心动图量化的人工二尖瓣反流连续患者（21例机械瓣和9例生物瓣）：4例轻度、13例中度和13例重度。反流容积（RV）和反流表面积（RSA）通过以下公式计算：RV = 2π.r2.Va.t.α/180，RSA = RV/VTI（r：汇聚区收缩中期半径，Va：混叠速度，t：反流时间，α/180：由于壁应力引起的角度校正，VTI：反流血流的速度时间积分）。RV和RSA计算的可行性分别为93%和63%。RV与经食管超声心动图之间（r：0.85，p < 0.001）、RSA与经食管超声心动图之间（r：0.67，p < 0.05）以及RV与RSA之间（r：0.95，p < 0.001）存在统计学显著相关性。当将RV大于60 ml和RSA大于40 mm2定义为重度人工瓣反流时，RV、RSA与经食管超声心动图之间的一致性分别为75%和74%。因此，通过经胸超声心动图研究汇聚区可对人工二尖瓣反流进行准确评估。
