Abaci Adnan, Oguzhan Abdurrahman, Unal Sükrü, Kiranatli Burhanettin, Eryol Namik Kemal, Basar Emrullah, Ergin Ali, Cetin Servet
Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
Cardiology. 2002;98(1-2):50-9. doi: 10.1159/000064675.
The vena contracta is the narrowest region of the regurgitant or stenotic jet just downstream the orifice and reflects the size of that orifice. This study was performed to assess the accuracy of the vena contracta width (VCW) in evaluating the severity of mitral stenosis (MS) and to compare the mitral valve area (MVA) determined by VCW with MVAs obtained by other more traditional echocardiographic methods.
We studied 59 patients (43 females, 42 +/- 14 years) with MS. VCW was measured in the apical four chamber view by Doppler color flow mapping. The largest diameter of the VCW during diastole was measured for at least three cardiac cycles and averaged. MVA was calculated from the following equation: pir(2), where r = VCW/2. MVA was also determined by planimetry, the pressure half-time method, and by the Gorlin formula.
In this study, the width of the vena contracta ranged from 0.89 to 1.73 cm (mean 1.30 +/- 0.21). MVA, calculated based on the VCW, ranged from 0.63 to 2.35 cm(2) (mean 1.36 +/- 0.41). MVA by VCW (1.36 +/- 0.41 cm(2)) showed good correlations with three comparative techniques: (1) the cross-sectional area by planimetry (1.35 +/- 0.36 cm(2), mean difference = 0.21 +/- 0.16 cm(2), y = 0.91x + 0.14, r = 0.79, SEE = 0.26 cm(2), p < 0.001); (2) the area derived from the Doppler pressure half-time (1.27 +/- 0.32 cm(2), mean difference = 0.22 +/- 0.19 cm(2), y = 0.97x + 0.13, r = 0.76, SEE = 0.27 cm(2), p < 0.001), and (3) the area derived from the Gorlin equation in the 18 patients who underwent catheterization (1.27 +/- 0.35 cm(2), mean difference = 0.19 +/- 0.16, y = 0.98x + 0.05, r = 0.81, SEE = 0.26 cm(2), p < 0.001).
These findings suggest that Doppler color flow imaging of the MS jet in the vena contracta can provide an accurate estimation of MVA and appears to be potentially applicable in the assessment of the severity of MS.
缩流颈是反流或狭窄射流在瓣口下游的最窄区域，反映了瓣口大小。本研究旨在评估缩流颈宽度（VCW）评估二尖瓣狭窄（MS）严重程度的准确性，并将根据VCW确定的二尖瓣瓣口面积（MVA）与通过其他更传统超声心动图方法获得的MVA进行比较。
我们研究了59例MS患者（43例女性，42±14岁）。通过多普勒彩色血流图在心尖四腔视图中测量VCW。在至少三个心动周期中测量舒张期VCW的最大直径并取平均值。MVA根据以下公式计算：πr²，其中r = VCW/2。MVA也通过面积测量法、压力减半时间法和Gorlin公式确定。
在本研究中，缩流颈宽度范围为0.89至1.73 cm（平均1.30±0.21）。根据VCW计算的MVA范围为0.63至2.35 cm²（平均1.36±0.41）。通过VCW得出的MVA（1.36±0.41 cm²）与三种比较技术显示出良好的相关性：（1）面积测量法得出的横截面积（1.35±0.36 cm²，平均差异 = 0.21±0.16 cm²，y = 0.91x + 0.14，r = 0.79，标准误 = 0.26 cm²，p < 0.001）；（2）多普勒压力减半时间得出的面积（1.27±0.32 cm²，平均差异 = 0.22±0.19 cm²，y = 0.97x + 0.13，r = 0.76，标准误 = 0.27 cm²，p < 0.001），以及（3）在18例接受心导管检查的患者中通过Gorlin公式得出的面积（1.27±0.35 cm²，平均差异 = 0.19±0.16，y = 0.98x + 0.05，r = 0.81，标准误 = 0.26 cm²，p < 0.001）。
这些发现表明，对MS射流在缩流颈处进行多普勒彩色血流成像可准确估计MVA，并且似乎有可能应用于评估MS的严重程度。
