Takenaka K, Sakamoto T, Dabestani A, Gardin J M, Henry W L
The Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
J Cardiol. 1987 Jun;17(2):301-9.
To ascertain whether the presence of retrograde holo-diastolic flow (RHF) in the ascending, descending or abdominal aorta is indicative of the severity of aortic regurgitation (AR), ascending, descending and abdominal aortic flow velocities were measured by pulsed Doppler echocardiography in 35 patients with AR and in 18 patients without AR, confirmed by aortography. Among the 35 patients with AR, 15 had mitral regurgitation, 11 had mitral stenosis, eight had aortic stenosis, five had prosthetic mitral valves, four had prosthetic aortic valves and two had aorto-pulmonary shunts. Satisfactory flow velocity recordings were obtained from the ascending aorta of 47 patients (89%), from the descending aorta of 39 patients (74%) and from the abdominal aorta of 43 patients (81%). In the ascending aorta, 30 of 32 AR patients with satisfactory recordings had RHF, while only one of the 15 patients without AR had RHF. None of the patients without AR had RHF, in either the descending or abdominal aorta. In the descending aorta, all 11 patients with 3+ or 4+ AR independently determined by aortography had RHF, while only three of 16 patients with 1+ or 2+ AR had RHF. Two of the three patients had aorto-pulmonary shunts. In the abdominal aorta, all 11 patients with 3+ or 4+ AR had RHF, while only one of the 22 patients with 1+ or 2+ AR had RHF. The latter patient had an aorto-pulmonary shunt. Identification of RHF in the descending or abdominal aorta is a useful means of distinguishing patients with severe AR from those with minimal or no AR.(ABSTRACT TRUNCATED AT 250 WORDS)
为确定升主动脉、降主动脉或腹主动脉中舒张期全时逆向血流(RHF)的存在是否可提示主动脉瓣反流(AR)的严重程度,通过脉冲多普勒超声心动图测量了35例经主动脉造影证实患有AR的患者以及18例无AR患者的升主动脉、降主动脉和腹主动脉血流速度。在35例AR患者中,15例有二尖瓣反流,11例有二尖瓣狭窄,8例有主动脉瓣狭窄,5例有人工二尖瓣,4例有人工主动脉瓣,2例有主-肺动脉分流。47例患者(89%)获得了满意的升主动脉血流速度记录,39例患者(74%)获得了满意的降主动脉血流速度记录,43例患者(81%)获得了满意的腹主动脉血流速度记录。在升主动脉中,32例有满意记录的AR患者中有30例存在RHF,而15例无AR患者中只有1例存在RHF。无AR患者在降主动脉或腹主动脉中均无RHF。在降主动脉中,经主动脉造影独立判定为3+或4+级AR的所有11例患者均有RHF,而16例1+或2+级AR患者中只有3例有RHF。这3例患者中有2例有主-肺动脉分流。在腹主动脉中,11例3+或4+级AR患者均有RHF,而22例1+或2+级AR患者中只有1例有RHF。后1例患者有主-肺动脉分流。降主动脉或腹主动脉中RHF的识别是区分重度AR患者与轻度或无AR患者的有用方法。(摘要截短至250字)