Subramanyan R, Srinivasan M, Joy J, Tharakan J, Titus T, Venkitachalam C G, Balakrishnan K G
Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum.
Indian Heart J. 1990 Sep-Oct;42(5):371-4.
Fifty consecutive patients with aortic stenosis were evaluated by continuous wave Doppler echocardiography for assessment of the transaortic gradient. The Doppler derived gradients were compared with the gradients measured at cardiac catheterisation. Excellent correlation was found between the Doppler and catheterisation findings for the maximum instantaneous gradient (r = 0.92) and the mean systolic gradient (r = 0.84). The maximum, midsystolic and late systolic Doppler gradients also showed a good correlation with the peak to peak catheter gradient. The maximum Doppler velocity however, showed overestimation of the peak to peak gradient in the presence of mild aortic stenosis (predictive accuracy 86%). The midsystolic Doppler velocity showed the highest predictive accuracy (94%) for the detection of severe aortic stenosis. No case of severe aortic stenosis was missed by Doppler using either the maximum or midsystolic Doppler velocity. These findings indicate that continuous wave Doppler ultrasound provides a reliable estimate of the gradient in patients with aortic stenosis.
连续50例主动脉瓣狭窄患者接受连续波多普勒超声心动图检查，以评估经主动脉压力阶差。将多普勒得出的压力阶差与心导管检查测得的压力阶差进行比较。结果发现，多普勒检查结果与心导管检查结果在最大瞬时压力阶差（r = 0.92）和平均收缩期压力阶差（r = 0.84）方面具有极好的相关性。最大、收缩中期和收缩晚期多普勒压力阶差与峰-峰导管压力阶差也显示出良好的相关性。然而，在轻度主动脉瓣狭窄的情况下，最大多普勒速度显示出对峰-峰压力阶差的高估（预测准确性为86%）。收缩中期多普勒速度对重度主动脉瓣狭窄的检测显示出最高的预测准确性（94%）。使用最大或收缩中期多普勒速度，多普勒检查均未漏诊重度主动脉瓣狭窄病例。这些发现表明，连续波多普勒超声可对主动脉瓣狭窄患者的压力阶差提供可靠的估计。
