Portman M A, Bhat A M, Cohen M H, Jacobstein M D
Division of Pediatric Cardiology, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, OH 44106.
Am Heart J. 1987 Nov;114(5):1178-82. doi: 10.1016/0002-8703(87)90194-3.
An echocardiographic index of left ventricular (LV) short axis circularity can be defined by the equation: left ventricular systolic circularity index (LVSCI) = 4 pi(LV area) X 100/(LV perimeter). This index was measured from two-dimensional echocardiograms in 98 children (ages 1 day to 19 years) with congenital heart disease, and results were compared to right ventricular/left ventricular peak systolic pressure ratios (RVP/LVP) determined at cardiac catheterization. LVSCI was also computed in 50 children without cardiovascular or pulmonary disease to define the normal range. A short axis image of the left ventricle at the level of the papillary muscles was obtained from the left parasternal position. Area and perimeter were determined by computer planimetry of the LV endocardium at end systole. LVSCI was measured from three consecutive beats and averaged. In the normal group all values of LVSCI exceeded 93% (mean 96%). In the group with congenital heart disease RVP/LVP correlated exponentially with LVSCI: RVP/LVP = e2.6-0.04 LVSCI; with r = 0.88, SEE = 0.39, and p less than 0.001. If patients with suprasystemic right ventricular pressures (RVP/LVP greater than 1.2) are excluded, there is a linear correlation between RVP/LVP and LVSCI: RVP/LVP = 2.3-0.021 LVSCI; with r = 0.80, SEE = 0.14, and p less than 0.001. LVSCI could distinguish between patients with normal, mildly elevated, moderately elevated, and severely elevated RVP/LVP. We conclude that LVSCI is a readily determined parameter that is independent of age or body size and predicts RVP/LVP in children with congenital heart disease.
左心室（LV）短轴圆度的超声心动图指数可由以下公式定义：左心室收缩期圆度指数（LVSCI）=4π（LV面积）×100/（LV周长）。对98例患有先天性心脏病的儿童（年龄1天至19岁）进行二维超声心动图测量该指数，并将结果与心导管检查测定的右心室/左心室收缩压峰值比（RVP/LVP）进行比较。还对50例无心血管或肺部疾病的儿童计算LVSCI以确定正常范围。从左胸骨旁位置获取乳头肌水平的左心室短轴图像。通过计算机平面测量法确定收缩末期LV心内膜的面积和周长。从连续三个心动周期测量LVSCI并取平均值。正常组中所有LVSCI值均超过93%（平均96%）。先天性心脏病组中，RVP/LVP与LVSCI呈指数相关：RVP/LVP = e2.6 - 0.04LVSCI；r = 0.88，标准误（SEE）= 0.39，p < 0.001。如果排除右心室压力高于体循环压力的患者（RVP/LVP大于1.2），则RVP/LVP与LVSCI之间存在线性相关：RVP/LVP = 2.3 - 0.021LVSCI；r = 0.80，SEE = 0.14，p < 0.001。LVSCI可区分RVP/LVP正常、轻度升高、中度升高和重度升高的患者。我们得出结论，LVSCI是一个易于测定的参数，独立于年龄或体型，可预测先天性心脏病儿童的RVP/LVP。
