Yeung A C, Plappert T, St John Sutton M G
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Br Heart J. 1992 Aug;68(2):236-40. doi: 10.1136/hrt.68.8.236.
The evaluation of aortic regurgitation by current echocardiographic techniques has been qualitative and load-dependent. The area of the regurgitant orifice, which is theoretically independent of haemodynamic conditions, has not been determined non-invasively. In 20 patients with various degrees of aortic regurgitation, this area was determined by use of the continuity equation applied during diastole. The velocity-time integrals were determined at the supravalvar (VTIs) and regurgitant orifice (VTIj) levels by pulsed and continuous wave Doppler respectively. The cross sectional area at the supravalvar level (As) was also measured by cross sectional echocardiography. The regurgitant orifice is given by: (As x VTIs)/VTIj. Other non-invasive measurements of the aortic regurgitation severity were also recorded: (a) an overall echo score (1-5+) given blindly by two echocardiographers, (b) the maximal proximal jet width by colour Doppler, (c) left ventricular end systolic and end diastolic volumes and left ventricular mass. The regurgitant area ranged from 0.25 to 1.7 cm2 and this area accorded with the overall echo score and the maximal proximal jet width measured by colour Doppler. The aortic regurgitation orifice area can be calculated non-invasively and it may be a quantitative measure of the severity of aortic regurgitation.
目前超声心动图技术对主动脉瓣反流的评估是定性的且依赖于负荷。反流口面积理论上独立于血流动力学状况，但尚未通过非侵入性方法测定。在20例不同程度主动脉瓣反流患者中，利用舒张期应用的连续性方程测定了该面积。分别通过脉冲多普勒和连续波多普勒测定了瓣上（VTIs）和反流口（VTIj）水平的速度时间积分。还通过超声心动图测量了瓣上水平的横截面积（As）。反流口面积由以下公式得出：（As×VTIs）/VTIj。还记录了其他主动脉瓣反流严重程度的非侵入性测量指标：（a）两位超声心动图医生盲法给出的总体回声评分（1 - 5+），（b）彩色多普勒测量的最大近端射流宽度，（c）左心室收缩末期和舒张末期容积以及左心室质量。反流面积范围为0.25至1.7平方厘米，该面积与总体回声评分以及彩色多普勒测量的最大近端射流宽度相符。主动脉瓣反流口面积可通过非侵入性方法计算得出，它可能是主动脉瓣反流严重程度的定量指标。
