通过平面测量法、戈林方程和连续性方程评估主动脉瓣狭窄时的瓣膜口面积：一项前瞻性研究。

Valve orifice area in aortic stenosis evaluated by planimetry, Gorlin and continuity equations: a prospective study.

作者信息

João Isabel, Cotrim Carlos, Duarte J A, Fazendas Paula, Catarino Carlos, Pereira Helder, Matias Fernando, de Oliveira L Moura, Carrageta Manuel

机构信息

Serviço de Cardiologia, Hospital Garcia de Orta, Almada.

出版信息

Rev Port Cardiol. 2002 Apr;21(4):421-34.

PMID:12090128

Abstract

UNLABELLED

In evaluation of the severity of aortic valve stenosis, multiple parameters can be determined. All of them, except valve orifice area, are influenced by other factors such as cardiac output, heart rate or aortic insufficiency.

OBJECTIVES

This is a prospective study which proposes, in the determination of the valve orifice area in aortic stenosis, to evaluate the accuracy of and correlation between three methods--planimetry by multiplane transesophageal echocardiography, the continuity equation by transthoracic echocardiography, and invasive measurement using the Gorlin formula.

METHODS

Forty-five patients with known calcified valvular aortic stenosis 27 men, mean age 70 +/- 10 years, (range 27-82), were studied. In all patients the area was determined by planimetry and by the continuity equation. In 25 (56%) patients invasive measurements were obtained using the Gorlin formula.

RESULTS

Evaluation of the valve orifice area by planimetry was easily performed and did not prolong the duration of the exam, except in five patients (11%). The area determined by the continuity equation had a mean value of 0.74 +/- 0.25 cm2, by planimetry 0.74 +/- 0.24 cm2 and by the Gorlin formula 0.65 +/- 0.17 cm2. Correlations between areas obtained by the three methods used were: continuity equation and planimetry 0.82; continuity equation and Gorlin formula 0.51; and planimetry and Gorlin formula 0.80. Concordance analysis (Bland and Altman's method) gave mean (Mn) values for the differences in the areas determined by the Gorlin formula and the continuity equation of 0.01 +/- 0.15 cm2 (Mn - 2SD = -0.29, Mn + 2SD = 0.30). The estimated value by the Gorlin formula and planimetry was 0.02 +/- 0.10 (Mn - 2SD = -0.19, Mn + 2SD = 0.23).

CONCLUSIONS

Planimetry of the valve orifice area by transesophageal echocardiography is feasible and does not prolong the duration of the exam in the majority of patients. 2) The strong correlation and the results of concordance analysis, in the determination of valve orifice area, between traditional invasive methods and planimetry, support the use of this noninvasive method in clinical practice.

摘要

未标注

在评估主动脉瓣狭窄的严重程度时，可以确定多个参数。除瓣膜口面积外，所有这些参数均受其他因素影响，如心输出量、心率或主动脉瓣关闭不全。

目的

这是一项前瞻性研究，旨在确定主动脉瓣狭窄的瓣膜口面积时，评估三种方法的准确性及相关性，这三种方法分别是：多平面经食管超声心动图的面积测量法、经胸超声心动图的连续性方程法以及使用戈林公式的有创测量法。

方法

对45例已知钙化性瓣膜性主动脉瓣狭窄患者进行研究，其中男性27例，平均年龄70±10岁（范围27 - 82岁）。所有患者均通过面积测量法和连续性方程法确定瓣膜口面积。25例（56%）患者使用戈林公式进行有创测量。

结果

除5例患者（11%）外，通过面积测量法评估瓣膜口面积操作简便，且未延长检查时间。通过连续性方程法确定的面积平均值为0.74±0.25平方厘米，面积测量法为0.74±0.24平方厘米，戈林公式法为0.65±0.17平方厘米。所使用的三种方法所测得面积之间的相关性为：连续性方程法与面积测量法为0.82；连续性方程法与戈林公式法为0.51；面积测量法与戈林公式法为0.80。一致性分析（布兰德和奥尔特曼法）得出戈林公式法与连续性方程法所测面积差异的平均值（Mn）为0.01±0.15平方厘米（Mn - 2SD = -0.29，Mn + 2SD = 0.30）。戈林公式法与面积测量法的估计值为0.02±0.10（Mn - 2SD = -0.19，Mn + 2SD = 0.23）。