能量损失系数对接受主动脉瓣置换术患者左心室质量消退的影响：初步观察

Impact of energy loss coefficient on left ventricular mass regression in patients undergoing aortic valve replacement: preliminary observation.

作者信息

Kume Teruyoshi, Okura Hiroyuki, Kawamoto Takahiro, Watanabe Nozomi, Neishi Yoji, Hayashida Akihiro, Tanemoto Kazuo, Yoshida Kiyoshi

机构信息

Department of Cardiology, Kawasaki Medical School, Kurashiki, Okayama, Japan.

出版信息

J Am Soc Echocardiogr. 2009 May;22(5):454-7. doi: 10.1016/j.echo.2009.02.018.

DOI:10.1016/j.echo.2009.02.018

PMID:19307101

Abstract

BACKGROUND

The purpose of this study was to evaluate the impact of Doppler-derived energy loss coefficient (ELCo) on the regression of left ventricular (LV) hypertrophy after aortic valve replacement (AVR) in patients with severe aortic stenosis.

METHODS

Twenty-four patients with severe aortic stenosis who underwent AVR with Carpentier-Edwards pericardial bioprosthetic valves (valve size 19 mm, n = 16; valve size 21 mm, n = 8) were examined. Within 12 months after AVR, follow-up echocardiography and Doppler measurements were performed. The effect of AVR was quantified on the basis of absolute and relative LV mass regression.

RESULTS

There were significant correlations between indexed ELCo and absolute (r = 0.50, P = .013) and relative (r = 0.48, P = .018) LV mass regression. The mean value of relative LV mass regression was 25%, and a cutoff value of 0.9 cm2/m2 for indexed ELCo could detect patients with relative LV mass regression > 25% after AVR with sensitivity of 71% and specificity of 100%.

CONCLUSIONS

ELCo, which can be calculated noninvasively from echocardiography, might be an important value to relate to LV mass regression in patients after AVR.

摘要

背景

本研究旨在评估多普勒衍生的能量损失系数（ELCo）对重度主动脉瓣狭窄患者主动脉瓣置换术（AVR）后左心室（LV）肥厚消退的影响。

方法

对24例行AVR并植入Carpentier-Edwards心包生物瓣膜（瓣膜尺寸19mm，n = 16；瓣膜尺寸21mm，n = 8）的重度主动脉瓣狭窄患者进行检查。在AVR后12个月内，进行随访超声心动图和多普勒测量。基于绝对和相对左心室质量消退对AVR的效果进行量化。

结果

指数化ELCo与绝对（r = 0.50，P = 0.013）和相对（r = 0.48，P = 0.018）左心室质量消退之间存在显著相关性。相对左心室质量消退的平均值为25%，指数化ELCo的截断值为0.9 cm2/m2可检测出AVR后相对左心室质量消退> 25%的患者，敏感性为71%，特异性为100%。