Başpinar Osman, Karaaslan Sevim, Oran Bülent
Department of Pediatric Cardiology, Gaziantep University Faculty of Medicine, 27310 Gaziantep, Turkey.
Anadolu Kardiyol Derg. 2005 Sep;5(3):167-71.
The purpose of this study was to determine the feasibility and significance of the proximal isovelocity surface area (PISA) method in children with rheumatic mitral regurgitation (MR).
Thirty-one children (mean age 12.3+/-3.1 years), with chronic MR, were evaluated by semiquantitative and quantitative Doppler, quantitative two-dimensional echocardiography and the PISA methods. Also, we compared the effective regurgitant orifice area, regurgitation volume and systolic left ventricular functions in mild-moderate and severe MR.
There were no statistically significant differences in the regurgitant orifice area and regurgitant volume values obtained by the PISA method and the quantitative Doppler (p>0.05) but they were different from the same values obtained by two dimensional echocardiography (p<0.05). There were excellent correlations between the regurgitant orifice area, regurgitant volume and the radius of the proximal flow convergence hemisphere (r=0.882, r=0.925, r=0.880; p<0.05). We found a very good correlation between the regurgitant orifice area obtained by the PISA and left ventricular end-diastolic diameters, the ratio of the jet/left atrial area, grading with color Doppler imaging (r=0.763, r=0.745, r=0.618; p<0.05).
It is concluded that MR can be accurately predicted in children by using the PISA method as like as the Doppler method.
本研究旨在确定近端等速表面积（PISA）法在风湿性二尖瓣反流（MR）患儿中的可行性及意义。
采用半定量和定量多普勒、定量二维超声心动图及PISA法对31例患有慢性MR的儿童（平均年龄12.3±3.1岁）进行评估。此外，我们比较了轻中度和重度MR患者的有效反流口面积、反流容积及左心室收缩功能。
PISA法和定量多普勒法测得的反流口面积和反流容积值无统计学显著差异（p>0.05），但与二维超声心动图测得的相同值不同（p<0.05）。反流口面积、反流容积与近端血流汇聚半球半径之间存在极佳的相关性（r=0.882，r=0.925，r=0.880；p<0.05）。我们发现PISA法测得的反流口面积与左心室舒张末期直径、射流/左心房面积比值、彩色多普勒成像分级之间存在很好的相关性（r=0.763，r=0.745，r=0.618；p<0.05）。
得出结论，使用PISA法与多普勒法一样能够准确预测儿童的MR。
