Yoshida K, Yoshikawa J, Akasaka T, Nishigami K, Minagoe S
Department of Cardiology, Kobe General Hospital, Japan.
J Am Coll Cardiol. 1992 Feb;19(2):333-8. doi: 10.1016/0735-1097(92)90487-8.
To test the value of acceleration flow signals proximal to the leaking orifice in assessing the severity of prosthetic mitral valve regurgitation, 39 consecutive patients undergoing left ventriculography were examined by Doppler color flow imaging. Acceleration flow signals proximal to the regurgitant orifice were detected in 27 of the 31 patients who had prosthetic mitral regurgitation by left ventriculography (sensitivity 87%). All four patients without acceleration flow signals had mild prosthetic mitral regurgitation by angiography. No acceleration flow signals were detected in any patient without prosthetic regurgitation by left ventriculography (specificity 100%). Individual values of the maximal area of acceleration flow signals obtained from three orthogonal planes in seven patients with mild prosthetic mitral regurgitation by angiography ranged from 0 to 17 mm2 (mean 4 +/- 6). In 8 patients with moderate prosthetic mitral regurgitation by angiography, the maximal area of acceleration flow signals ranged from 21 to 58 mm2 (mean 33 +/- 15), whereas the maximal area of acceleration flow signals in 16 patients with severe prosthetic regurgitation ranged from 20 to 173 mm2 (mean 102 +/- 41). The maximal area of the acceleration flow signals from three planes correlated well with the angiographic grade of prosthetic mitral regurgitation. There was a significant difference in the maximal area of acceleration flow signals between mild and moderate (p less than 0.001), moderate and severe (p less than 0.001) and mild and severe (p less than 0.001) prosthetic mitral regurgitation. Thus, measurement of acceleration flow signals by Doppler color flow imaging is useful in assessing the severity of prosthetic mitral regurgitation.
为了检验在评估人工二尖瓣反流严重程度时，反流口近端加速血流信号的价值，对39例连续接受左心室造影的患者进行了多普勒彩色血流成像检查。在经左心室造影证实有二尖瓣反流的31例患者中，27例检测到反流口近端的加速血流信号（敏感性87%）。4例未检测到加速血流信号的患者经血管造影显示为轻度人工二尖瓣反流。左心室造影未发现人工反流的患者均未检测到加速血流信号（特异性100%）。7例血管造影显示轻度人工二尖瓣反流患者，从三个正交平面获得的加速血流信号最大面积的个体值范围为0至17mm²（平均4±6）。8例血管造影显示中度人工二尖瓣反流患者，加速血流信号最大面积范围为21至58mm²（平均33±15），而16例重度人工反流患者的加速血流信号最大面积范围为20至173mm²（平均102±41）。三个平面的加速血流信号最大面积与人工二尖瓣反流的血管造影分级相关性良好。轻度与中度（p<0.001）、中度与重度（p<0.001）以及轻度与重度（p<0.001）人工二尖瓣反流之间，加速血流信号最大面积存在显著差异。因此，通过多普勒彩色血流成像测量加速血流信号有助于评估人工二尖瓣反流的严重程度。
