Feneley M P, Gaynor J W, Maier G W, Gall S A, Kisslo J A, Rankin J S
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Am J Physiol. 1988 Dec;255(6 Pt 2):H1399-404. doi: 10.1152/ajpheart.1988.255.6.H1399.
Several geometric algorithms have been applied to estimate left ventricular wall volume (Vwall) from two-dimensional echocardiograms but have not been validated in eccentrically hypertrophied hearts. These algorithms can be fitted to the general formula: Vwall = k.Ao.Lo = k.Ai.Li, where Ao and Ai are the outer (epicardial) and inner (endocardial) short-axis areas, Lo and Li are the corresponding long-axis lengths, and k is a constant. The simplifying assumption that Lo and Li are equal yields Vwall = k.Awall.Lo, where Awall = Ao - Ai. In 20 unsedated dogs (10-30 kg), including 10 with aortic regurgitation of 1-18 wk duration, the relationship between actual Vwall (determined postmortem) and Awall.Lo was not significantly different from the line of identity (Vwall = 1.01 Awall.Lo + 0.5 ml, r = 0.98, SEE = 3.5 ml), indicating k was not significantly different from 1. There was no significant difference between predicted and actual Vwall over a range of 31-105 ml, and interobserver variability was 4.1%. The simple area-length product, Awall.Lo, accurately predicts Vwall of both normal and volume-overloaded hypertrophied canine left ventricles and is thus suitable for serial observations of hypertrophic adaptation to volume overload.
已有多种几何算法应用于从二维超声心动图估算左心室壁容积（Vwall），但尚未在偏心肥厚型心脏中得到验证。这些算法可拟合为通用公式：Vwall = k.Ao.Lo = k.Ai.Li，其中Ao和Ai分别为外（心外膜）和内（心内膜）短轴面积，Lo和Li为相应的长轴长度，k为常数。假设Lo和Li相等可简化为Vwall = k.Awall.Lo，其中Awall = Ao - Ai。在20只未麻醉的犬（体重10 - 30 kg）中，包括10只患有持续1 - 18周主动脉瓣反流的犬，实际Vwall（死后测定）与Awall.Lo之间的关系与恒等线（Vwall = 1.01 Awall.Lo + 0.5 ml，r = 0.98，SEE = 3.5 ml）无显著差异，表明k与1无显著差异。在31 - 105 ml范围内，预测Vwall与实际Vwall无显著差异，观察者间变异性为4.1%。简单的面积 - 长度乘积Awall.Lo能准确预测正常和容量超负荷肥厚型犬左心室的Vwall，因此适用于对肥厚型适应容量超负荷的系列观察。
