Nishimura R A, Holmes D R, Reeder G S, Tajik A J, Hatle L K
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J Am Coll Cardiol. 1988 Jun;11(6):1219-26. doi: 10.1016/0735-1097(88)90285-9.
To evaluate the hemodynamic changes occurring with percutaneous aortic balloon valvuloplasty for aortic stenosis, Doppler echocardiography was performed during the procedure in 16 patients. During balloon inflation, peak velocity and ejection time of the aortic valve systolic signals increased (26 and 30%, respectively; p less than 0.001). Aortic regurgitation deceleration time decreased from 1,337 to 625 ms (p less than 0.001). In three patients, aortic regurgitation stopped before end-diastole; in four patients, end-diastole forward flow across the aortic valve was documented. The deceleration time of the mitral valve inflow signal decreased from 303 to 194 ms (p less than 0.001) during balloon inflation, concurrently with an increase in left ventricular diastolic pressure. Mitral regurgitation signals became more prominent during inflation in 10 patients. Changes that occur during balloon inflation in the aortic valve include progressive left ventricular outflow obstruction, equalization of diastolic aortic and left ventricular pressures and changes in diastolic compliance.
为评估经皮主动脉球囊瓣膜成形术治疗主动脉瓣狭窄时发生的血流动力学变化，对16例患者在手术过程中进行了多普勒超声心动图检查。在球囊扩张期间，主动脉瓣收缩期信号的峰值速度和射血时间增加（分别增加26%和30%；p<0.001）。主动脉瓣反流减速时间从1337毫秒降至625毫秒（p<0.001）。3例患者在舒张末期前主动脉瓣反流停止；4例患者记录到舒张末期主动脉瓣前向血流。在球囊扩张期间，二尖瓣流入信号的减速时间从303毫秒降至194毫秒（p<0.001），同时左心室舒张压升高。10例患者在球囊扩张时二尖瓣反流信号变得更明显。主动脉瓣球囊扩张期间发生的变化包括进行性左心室流出道梗阻、舒张期主动脉压和左心室压的平衡以及舒张期顺应性的变化。
