Nakatani S, Nagata S, Beppu S, Ishikura F, Tamai J, Yamagishi M, Ohmori F, Kimura K, Takamiya M, Miyatake K
National Cardiovascular Center, Research Institute and Hospital, Osaka, Japan.
Am Heart J. 1991 Mar;121(3 Pt 1):770-5. doi: 10.1016/0002-8703(91)90187-m.
Mitral valve areas before and after balloon mitral valvuloplasty were serially determined by the Doppler continuity equation method in 16 patients. Ultrasound examinations were performed before and immediately after balloon inflation and 24 hours, 1 week, and 1 month after valvuloplasty. Mitral valve area determined by the Doppler continuity equation method correlated well with that determined at catheterization by the Gorlin formula, not only before but also immediately after balloon inflation (y = 0.87 x + 0.05, standard error of estimate = 0.22 cm2, r = 0.90). Serial calculation of mitral valve area by the Doppler continuity equation method showed a slight but significant decrease in the valve area at 24 hours after balloon mitral valvuloplasty but no change after that. We conclude that the Doppler continuity equation method provides an accurate estimation of mitral valve area before and even after balloon valvuloplasty. Mitral valve area dilated by balloon inflation is decreased slightly within 24 hours after the procedure, which corroborates valve stretch as one mechanism for increasing mitral valve area with balloon valvuloplasty. Estimation of mitral valve area immediately after balloon mitral valvuloplasty may overestimate the long-term efficacy of the procedure.
采用多普勒连续方程法对16例患者在球囊二尖瓣成形术前及术后的二尖瓣面积进行了连续测定。在球囊充盈前、充盈后即刻以及成形术后24小时、1周和1个月进行超声检查。采用多普勒连续方程法测定的二尖瓣面积与通过戈林公式在导管检查时测定的二尖瓣面积相关性良好，不仅在球囊充盈前，在球囊充盈后即刻也是如此（y = 0.87x + 0.05，估计标准误差 = 0.22 cm²，r = 0.90）。通过多普勒连续方程法对二尖瓣面积进行连续计算显示，球囊二尖瓣成形术后24小时瓣膜面积有轻微但显著的减小，之后则无变化。我们得出结论，多普勒连续方程法能够准确估计球囊瓣膜成形术前甚至术后的二尖瓣面积。球囊充盈使二尖瓣面积扩张，术后24小时内会略有减小，这证实瓣膜伸展是球囊瓣膜成形术增加二尖瓣面积的一种机制。球囊二尖瓣成形术后即刻对二尖瓣面积的估计可能会高估该手术的长期疗效。
