Huml D, Beus-Huml M, Buksa M, Numić N
Energoinvest's Institute for Health Protection, Sarajevo.
Acta Med Croatica. 1992;46(2):91-9.
Phonomechanocardiographic and ultrasonocardiographic parameters were compared in the multiplex manner in order to assess a degree of narrowing of the stenotic aortic valve areas. Adult patients with aortic valve stenosis were included in the study. The main condition for admission in the research sample was that the mean rate of circumferential fibre shortening be greater than 1 s-1 i.e. "compensated" preejection period/ejection time ratio (PEP/LVET). The control group were persons as sample stratified from healthy population. A possibility of approximate assessment of valve areas in patients with aortic stenosis is rendered by inserting the phonomechanocardiographic parameters in the modified Gorlin and Gorlin formula, provided that values of the normalised ejection function index (PEP/LVET2) and the ejection-isovolumetric coefficient corrected for pulse transmission time (LVET/IVCT+PTT) are known. The phonomechanocardiographic indexes of the transvalvular aortic pressure gradient and normalised stroke volume correlate curvilinear. The value of the LVET/IVCT + PTT equal or greater than that extrapolated for the given PEP/LVET2 in our formula means critically stenotic aortic valve area below 0.8 cm2. The given approximation could be used as a noninvasive and nongeometric polycardiographic or phonomechanocardiographic pattern for assessing the degree of narrowing of aortic valve area. The aortic valve stenosis is an illness in which a lot is expected from noninvasive cardiologic parameters when a surgical indication is in question. A severe or tight aortic valve stenosis, which required a surgical treatment according to current views, existed when valve area is less than 0.8 cm2 or when the transvalvular aortic systolic pressure gradient is greater than 50 mm Hg or 6.67 kPa, but with normal cardiac index in the same time.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估狭窄主动脉瓣区域的狭窄程度,对心音心动图和超声心动图参数进行了多重比较。研究纳入了患有主动脉瓣狭窄的成年患者。研究样本的主要入选条件是圆周纤维缩短平均速率大于1 s-1,即“代偿性”射血前期/射血时间比值(PEP/LVET)。对照组是从健康人群中分层抽取的样本。如果已知标准化射血功能指数(PEP/LVET2)和经脉搏传播时间校正的射血-等容系数(LVET/IVCT+PTT)的值,将心音心动图参数代入改良的戈林公式,就可以对主动脉狭窄患者的瓣膜面积进行近似评估。跨瓣主动脉压力梯度的心音心动图指标与标准化搏出量呈曲线相关。在我们的公式中,LVET/IVCT + PTT的值等于或大于给定PEP/LVET2的外推值,意味着主动脉瓣面积严重狭窄低于0.8 cm2。这种近似评估可作为一种非侵入性且非几何学的多心电图或心音心动图模式,用于评估主动脉瓣面积的狭窄程度。当涉及手术指征时,主动脉瓣狭窄是一种有望从非侵入性心脏参数中获取大量信息的疾病。根据当前观点,当瓣膜面积小于0.8 cm2或跨瓣主动脉收缩压梯度大于50 mmHg或6.67 kPa,且同时心脏指数正常时,存在需要手术治疗的严重或重度主动脉瓣狭窄。(摘要截选至250字)