Möller S, Heublein B
Universitätsklinik für Innere Medizin Theodor Brugsch, Bereiches Medizin (Charité), Humboldt-Universität, Berlin, DDR.
Cor Vasa. 1987;29(5):369-80.
With the aim of minimizing the risk and stress of an invasive diagnostics, 102 patients with acquired heart valve diseases were examined by two-dimensional echocardiography combined with pulsed Doppler technique. The results were compared with those obtained at invasive diagnostics in 91 and/or during surgery in 52 of the patients studied. In the group of operated patients the sensitivity of non-invasive diagnostics was 89.5%, specificity 97.2%; analogous data for patients not subjected to surgery were 91.8% and 93.8%, respectively. The results of the study show that in the majority of patients with acquired valvular disease a complete preoperative invasive investigation is not necessary. Only in patients over 50 years of age the intended valve replacement should be preceded by additional coronarographic examination, as in 6.8% of cases--even without kinetic disturbances at rest--a haemodynamically important stenosis was found on at least one coronary artery.
为将侵入性诊断的风险和压力降至最低,对102例获得性心脏瓣膜病患者采用二维超声心动图结合脉冲多普勒技术进行了检查。将结果与91例患者侵入性诊断及52例患者手术期间获得的结果进行了比较。在手术患者组中,非侵入性诊断的敏感性为89.5%,特异性为97.2%;未接受手术患者的类似数据分别为91.8%和93.8%。研究结果表明,对于大多数获得性瓣膜病患者,术前无需进行全面的侵入性检查。仅对于50岁以上的患者,在进行预期的瓣膜置换之前应进行额外的冠状动脉造影检查,因为在6.8%的病例中——即使静息时无动力学紊乱——至少在一条冠状动脉上发现了具有血流动力学意义的狭窄。