Oh J K, Hatle L K, Sinak L J, Seward J B, Tajik A J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J Am Coll Cardiol. 1989 Dec;14(7):1712-7. doi: 10.1016/0735-1097(89)90021-1.
In symptomatic severe aortic regurgitation, left ventricular diastolic pressure increases rapidly, often exceeding left atrial pressure in late diastole. This characteristic hemodynamic change should be reflected in the Doppler mitral inflow velocity, which is the direct result of the diastolic pressure difference between the left ventricle and left atrium. Mitral inflow velocity was obtained by pulsed wave Doppler echocardiography in 11 patients (6 men, 5 women: mean age 53 years) with severe symptomatic aortic regurgitation and compared with normal values from 11 sex- and age-matched control subjects. The following Doppler variables were determined: velocity of early filling wave (E), velocity of late filling wave due to atrial contraction (A), E to A ratio (E/A), deceleration time and pressure half-time. In severe aortic regurgitation, E and E/A (1.13 m/s and 3.3, respectively) were significantly higher (p less than 0.001) than normal (0.60 m/s and 1.5, respectively). Deceleration time and pressure half-time (117 and 34 ms, respectively) were significantly shorter (p less than 0.001) than normal (203 and 59 ms, respectively). Late filling wave velocity (A) was not statistically different in the two groups, although it tended to be lower in the patient group (0.39 versus 0.50 m/s). Diastolic mitral regurgitation was present in eight patients (73%). M-mode echocardiography of the mitral valve, performed in 10 patients, showed that only 3 (30%) had premature mitral valve closure. In symptomatic severe aortic regurgitation, the Doppler mitral inflow velocity pattern is characteristic, with increased early filling wave velocity (E) and early to late filling wave ratio (E/A) and decreased deceleration time of the E wave.(ABSTRACT TRUNCATED AT 250 WORDS)
在有症状的严重主动脉瓣反流中，左心室舒张压迅速升高，常在舒张末期超过左心房压力。这种典型的血流动力学改变应反映在多普勒二尖瓣流入速度上，这是左心室与左心房之间舒张压差的直接结果。采用脉冲波多普勒超声心动图测量了11例有症状的严重主动脉瓣反流患者（6例男性，5例女性；平均年龄53岁）的二尖瓣流入速度，并与11例年龄和性别匹配的对照受试者的正常值进行比较。测定了以下多普勒变量：早期充盈波速度（E）、心房收缩导致的晚期充盈波速度（A）、E/A比值、减速时间和压力减半时间。在严重主动脉瓣反流中，E和E/A（分别为1.13 m/s和3.3）显著高于正常水平（分别为0.60 m/s和1.5，p<0.001）。减速时间和压力减半时间（分别为117和34 ms）显著短于正常水平（分别为203和59 ms，p<0.001）。两组间晚期充盈波速度（A）无统计学差异，尽管患者组有降低趋势（0.39对0.50 m/s）。8例患者（73%）存在舒张期二尖瓣反流。对10例患者进行二尖瓣M型超声心动图检查，结果显示仅3例（30%）有二尖瓣提前关闭。在有症状的严重主动脉瓣反流中，多普勒二尖瓣流入速度模式具有特征性，即早期充盈波速度（E）和早期与晚期充盈波比值（E/A）增加，E波减速时间缩短。（摘要截短于250词）
