Teien D, Karp K, Eriksson P, Bjerle P, Osterman G
Int J Cardiol. 1987 May;15(2):205-14. doi: 10.1016/0167-5273(87)90316-0.
To assess the severity of outlfow obstruction in patients with aortic valve disease, the aortic valvar area was noninvasively determined in 22 patients with isolated aortic stenosis or combined stenosis and regurgitation. The ejection time (ET), maximal velocity (Vmax), and systolic velocity integral (SVI) of the aortic flow was obtained by continuous wave Doppler ultrasound. Left ventricular stroke volume (SV) was determined by radionuclide angiography, using a counts-based nongeometric technique with individual attenuation correction. Aortic valve area (AVA) was calculated using a modified Gorlin formula; AVA = SV/(71.2 X ET X Vmax), and also by dividing the stroke volume by the systolic velocity integral; AVA = SV/SVI. The two noninvasive determinations correlated closely with the valve areas obtained by invasive measurements; r = 0.95, SEE = +/- 0.13 cm2 by the modified Gorlin formula, and r = 0.94, SEE = +/- 0.14 cm2 by the integration method. The two noninvasive calculations showed almost uniform results; r = 0.98, SEE = +/- 0.09 cm2. In conclusion, aortic valve area can be determined with reasonable accuracy by combining Doppler echocardiography and radionuclide angiography. This noninvasive approach may reduce the need for invasive measurements in patients with suspected aortic valve disease. In addition, radionuclide angiography provides important information about left ventricular function.
为评估主动脉瓣疾病患者的流出道梗阻严重程度，对22例单纯主动脉瓣狭窄或合并狭窄及反流的患者进行了主动脉瓣面积的无创测定。通过连续波多普勒超声获取主动脉血流的射血时间（ET）、最大流速（Vmax）和收缩期流速积分（SVI）。采用基于计数的非几何技术并进行个体衰减校正，通过放射性核素血管造影测定左心室搏出量（SV）。使用改良的戈林公式计算主动脉瓣面积（AVA）；AVA = SV/（71.2×ET×Vmax），也可通过将搏出量除以收缩期流速积分来计算；AVA = SV/SVI。这两种无创测定方法与通过有创测量获得的瓣膜面积密切相关；改良戈林公式法的r = 0.95，标准误（SEE）为±0.13 cm²，积分法的r = 0.94，SEE为±0.14 cm²。两种无创计算结果几乎一致；r = 0.98，SEE为±0.09 cm²。总之，结合多普勒超声心动图和放射性核素血管造影可较为准确地测定主动脉瓣面积。这种无创方法可能会减少疑似主动脉瓣疾病患者进行有创测量的需求。此外，放射性核素血管造影可提供有关左心室功能的重要信息。
