Grayburn P A, Handshoe R, Smith M D, Harrison M R, DeMaria A N
J Am Coll Cardiol. 1987 Jul;10(1):135-41. doi: 10.1016/s0735-1097(87)80171-7.
The purpose of this study was to evaluate the ability of continuous wave Doppler ultrasound recordings to reflect the magnitude and hemodynamic effects of aortic regurgitation. Forty-five patients with angiographically proved aortic regurgitation had Doppler studies performed within 24 hours of cardiac catheterization. High quality spectral recordings of the regurgitant jet were obtained in 31 patients, whereas 14 patients exhibited dropout of high velocity signals precluding measurement of maximal velocities. The slope of the peak to end-diastolic velocity decrease measured by Doppler examination was compared with the decay in the aortic to left ventricular diastolic pressure gradient by catheterization and was found to correlate well (r = 0.86). The Doppler velocity decay slope was generally higher in patients with angiographically severe rather than mild or moderate aortic regurgitation, but considerable overlap was present among groups. However, a diastolic velocity decay slope of greater than 3 m/s2 was seen only in those patients with advanced (3 or 4+) aortic regurgitation. Left ventricular end-diastolic pressure was estimated from the Doppler recordings by subtracting the end-diastolic pressure gradient obtained by the modified Bernoulli equation from the cuff diastolic blood pressure. A correlation was observed (r = 0.84) between Doppler and catheterization left ventricular end-diastolic pressure in the 31 patients with high quality spectral data, although the SEE was substantial (5.5 mm Hg). These data demonstrate that continuous wave Doppler recordings of the regurgitant jet can be useful in assessing the angiographic severity and hemodynamics of aortic regurgitation.
本研究的目的是评估连续波多普勒超声记录反映主动脉瓣反流的程度及血流动力学效应的能力。45例经血管造影证实有主动脉瓣反流的患者在心脏导管插入术24小时内进行了多普勒检查。31例患者获得了反流束的高质量频谱记录，而14例患者出现高速信号丢失，无法测量最大速度。将多普勒检查测得的峰值至舒张末期速度下降的斜率与通过导管插入术测得的主动脉至左心室舒张期压力阶差的衰减进行比较，发现两者相关性良好（r = 0.86）。血管造影显示为重度而非轻度或中度主动脉瓣反流的患者，其多普勒速度衰减斜率通常更高，但各组之间存在相当程度的重叠。然而，仅在那些患有重度（3或4+）主动脉瓣反流的患者中观察到舒张期速度衰减斜率大于3 m/s²。通过用袖带舒张压减去经改良伯努利方程获得的舒张末期压力阶差，从多普勒记录中估算左心室舒张末期压力。在31例有高质量频谱数据的患者中，观察到多普勒与导管插入术测得的左心室舒张末期压力之间存在相关性（r = 0.84），尽管标准估计误差较大（5.5 mmHg）。这些数据表明，反流束的连续波多普勒记录可用于评估主动脉瓣反流的血管造影严重程度和血流动力学情况。
