Griffith Center, Division of Cardiovascular Medicine, Department of Medicine, LAC-USC Medical Center, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA.
J Am Coll Cardiol. 2012 Sep 25;60(13):1123-35. doi: 10.1016/j.jacc.2012.05.035.
The concept/phenomenon of valve prosthesis/patient mismatch (VP-PM), described in 1978, has stood the test of time. From that time to 2011, VP-PM has received a great deal of attention but studies have come to varying conclusions. This is largely because of the determination of prosthetic heart valve area [called effective orifice area index (EOAi)] by projection rather than by actual measurement, variable criteria to assess severity of EOAi and the timing of determination of EOAi. All prosthetic heart valves have some degree of VP-PM which must be placed in a proper clinical perspective. This can be done by determining its effects on function and outcomes. For mortality one needs to focus especially on severe/critical degree of VP-PM and determine the cause of death was due to VP-PM. For the period "beyond 2011" a road map is suggested that will have uniformity of assessment of VP-PM and a focusing on the important goals of VP-PM.
1978 年提出的瓣膜假体/患者不匹配（VP-PM）概念/现象经受住了时间的考验。从那时到 2011 年，VP-PM 引起了广泛关注，但研究结果却各不相同。这主要是因为通过投影而不是实际测量来确定人工心脏瓣膜面积（称为有效瓣口面积指数（EOAi）），评估 EOAI 严重程度的标准各不相同，以及确定 EOAI 的时间也不同。所有人工心脏瓣膜都存在一定程度的 VP-PM，必须将其置于适当的临床视角。这可以通过确定其对功能和结果的影响来实现。对于死亡率，尤其需要关注严重/临界程度的 VP-PM，并确定死亡原因是否是由于 VP-PM。对于“2011 年以后”的时期，建议制定路线图，以便对 VP-PM 进行统一评估，并重点关注 VP-PM 的重要目标。
