Bech-Hanssen Odd, Polte Christian Lars, Lagerstrand Kerstin M, Johnsson Åse A, Fadel Bahaa M, Gao Sinsia A
a Department of Cardiology , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden ;
b Department of Clinical Physiology , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden ;
Scand Cardiovasc J. 2016 Jun;50(3):154-61. doi: 10.3109/14017431.2016.1148195. Epub 2016 Feb 18.
Objectives Cut-off values for left ventricular (LV) dimensions indicating severe valve regurgitation have not been defined. The aim of this study was to establish echocardiographic cut-off values for LV dimensions indicating severe chronic aortic (AR) or mitral (MR) regurgitation. Design The hemodynamic significance was confirmed by documented reduction of end-diastolic volume (EDV) and symptom relief after surgery. Eighty-three patients with moderate or severe regurgitation (AR, n = 41; MR, n = 42) without other cardiac conditions underwent prospectively two-dimensional (2DE), real-time three-dimensional (RT3DE) echocardiography and cardiovascular magnetic resonance (CMR) exams within 4 h. Results The relationship between EDVCMR and EDV2DE and EDVRT3DE were strong (R 0.95 and 0.91). EDV index cut-offs for 2DE/RT3DE >87/104 ml/m(2) identified AR patients with severe regurgitation with a positive likelihood ratio (PLR) of 5.0/5.0. The corresponding in patients with MR EDV index cut-offs were >69/87 ml/m(2) with a PLR of 14.9/5.5. LV linear dimensions could not identify patients with severe regurgitation. Conclusions LV volumes by echocardiography can support the diagnosis of severe chronic regurgitation. Importantly, other causes for LV enlargement have to be considered.
目的 尚未确定提示严重瓣膜反流的左心室（LV）尺寸的临界值。本研究的目的是建立提示严重慢性主动脉瓣反流（AR）或二尖瓣反流（MR）的LV尺寸的超声心动图临界值。设计 通过记录舒张末期容积（EDV）的减少和手术后症状缓解来证实血流动力学意义。83例无其他心脏疾病的中度或重度反流患者（AR，n = 41；MR，n = 42）在4小时内前瞻性地接受了二维（2DE）、实时三维（RT3DE）超声心动图和心血管磁共振（CMR）检查。结果 EDVCMR与EDV2DE和EDVRT3DE之间的关系密切（R分别为0.95和0.91）。2DE/RT3DE的EDV指数临界值>87/104 ml/m²可识别重度反流的AR患者，阳性似然比（PLR）为5.0/5.0。MR患者的相应EDV指数临界值>69/87 ml/m²，PLR为14.9/5.5。LV线性尺寸无法识别重度反流患者。结论 超声心动图测量的LV容积有助于诊断严重慢性反流。重要的是，必须考虑导致LV扩大的其他原因。
