Poutanen T, Tikanoja T, Sairanen H, Jokinen E
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
Pediatr Cardiol. 2006 Mar-Apr;27(2):217-25. doi: 10.1007/s00246-005-1056-7.
Our purpose was to investigate the effects of body size on the sizes of mitral (MV) and aortic valve (AV) areas by three-dimensional (3-D) and two-dimensional (2-D) echocardiography and to create the normal values for 3-D echocardiography. A total of 168 healthy subjects aged 2-27 years were studied by digitized 3-DE, 2-DE, and Doppler echocardiography.3-D echocardiography was performed by using rotational acquisition of planes at 18 degrees intervals from a parasternal view with electrocardiogram gating and without respiratory gating. The annular levels of MV and AV were identified from short-axis cut planes and their areas were measured by planimetry. The diameters of mitral annulus, left ventricular outflow tract (LVOT), and aortic annulus were measured by 2-DE from the apical and parasternal long-axis views. Flow indices were measured by Doppler from MV inflow and the flow in LVOT and in the ascending aorta. Both MV and AV annular areas increased linearly in relation to body size. In the total study group the estimated areas for MV were 5.2 +/- 0.9 cm2/m2 by 3-DE, 3.7 +/- 0.5 cm2/m2 by 2-DE, and 2.0 +/- 0.4 cm2/m2 by continuity equation. The respective values for AV were 2.7 +/- 0.5, 2.1 +/- 0.3, and 1.8 +/- 0.4 cm2/m2. MV velocity time integral (VTI)/ascending aorta VTI increased from 0.80 (0.26) to 0.95 (0.23) with increased body surface area (BSA), whereas MV VTI/LVOT VTI was 1.2 (0.2) in all BSA groups. MV and AV annulus areas increase linearly in relation to body size. 3-DE gives greater estimates for the areas than 2-DE and Doppler equation methods. The data obtained from 168 healthy subjects may serve as a reference for clinical use in patients with various cardiac abnormalities.
我们的目的是通过三维（3-D）和二维（2-D）超声心动图研究体型对二尖瓣（MV）和主动脉瓣（AV）面积大小的影响，并建立3-D超声心动图的正常值。对168名年龄在2至27岁的健康受试者进行了数字化三维超声心动图、二维超声心动图和多普勒超声心动图检查。3-D超声心动图检查采用从胸骨旁视图以18度间隔进行平面旋转采集，同时进行心电图门控且不进行呼吸门控。从短轴切面确定MV和AV的瓣环水平，并通过面积测量法测量其面积。通过二维超声心动图从心尖和胸骨旁长轴视图测量二尖瓣环、左心室流出道（LVOT）和主动脉瓣环的直径。通过多普勒测量MV流入、LVOT和升主动脉内的血流指数。MV和AV瓣环面积均随体型呈线性增加。在整个研究组中，通过3-D超声心动图测得的MV估计面积为5.2±0.9 cm²/m²，通过2-D超声心动图测得的为3.7±0.5 cm²/m²，通过连续性方程测得的为2.0±0.4 cm²/m²。AV的相应值分别为2.7±0.5、2.1±0.3和1.8±0.4 cm²/m²。随着体表面积（BSA）增加，MV速度时间积分（VTI）/升主动脉VTI从0.80（0.26）增加到0.95（0.23），而在所有BSA组中MV VTI/LVOT VTI均为1.2（0.2）。MV和AV瓣环面积随体型呈线性增加。与2-D超声心动图和多普勒方程法相比，3-D超声心动图对面积的估计值更大。从168名健康受试者获得的数据可为各种心脏异常患者的临床应用提供参考。
