Trappe H J, Daniel W G, Frank G, Lichtlen P R
Department of Internal Medicine, Medical School, Hannover, West Germany.
Am Heart J. 1987 Dec;114(6):1399-406. doi: 10.1016/0002-8703(87)90543-6.
In 27 patients with aortic regurgitation and nine patients with associated aortic stenosis, the incidence of reverse doming was studied by two-dimensional echocardiography and was compared with diastolic fluttering of the mitral valve. Reverse doming could be identified in four of six patients (66.7%) with mild aortic regurgitation and in 20 of 21 patients (95.2%) with moderate or severe aortic regurgitation (p less than 0.05). Fluttering of the anterior mitral leaflet was observed in all patients with mild aortic insufficiency and in 19 of 21 patients (90.5%) with moderate or severe aortic insufficiency. In patients with associated aortic stenosis, reverse doming was observed in three patients (33.3%), whereas fluttering was seen in six patients (66.7%). After aortic valve replacement, reverse doming persisted in one patient with a paravalvular leak. Reverse doming or fluttering was not seen in healthy volunteers or in 10 patients with congestive cardiomyopathy. Our data indicate that reverse doming is a helpful parameter for the diagnosis of aortic regurgitation.
在27例主动脉瓣反流患者和9例合并主动脉瓣狭窄患者中，通过二维超声心动图研究了反向圆顶现象的发生率，并与二尖瓣舒张期扑动进行了比较。在6例轻度主动脉瓣反流患者中有4例（66.7%）可识别出反向圆顶现象，在21例中度或重度主动脉瓣反流患者中有20例（95.2%）可识别出反向圆顶现象（P<0.05）。在所有轻度主动脉瓣关闭不全患者以及21例中度或重度主动脉瓣关闭不全患者中的19例（90.5%）中观察到二尖瓣前叶扑动。在合并主动脉瓣狭窄的患者中，3例（33.3%）观察到反向圆顶现象，而6例（66.7%）观察到扑动现象。主动脉瓣置换术后，1例合并瓣周漏的患者仍存在反向圆顶现象。在健康志愿者或10例充血性心肌病患者中未观察到反向圆顶现象或扑动现象。我们的数据表明，反向圆顶现象是诊断主动脉瓣反流的一个有用参数。
