Breisblatt W, Goodyer A V, Zaret B L, Francis C K
Am J Cardiol. 1986 May 1;57(13):1105-8. doi: 10.1016/0002-9149(86)90683-1.
The ratio of end-systolic wall stress (ESWS) to volume index (ESVI) has been proposed as a useful index of left ventricular (LV) function in chronic mitral regurgitation (MR). However, although this ratio reflects isometric contraction, the chronic changes in LV architecture caused by MR may affect its usefulness. An index was evaluated that incorporated the ejection fraction--(TVEF [tension-volume ejection fraction] = ESWS/ESVI X EF)--thus combining both isometric and ejection phase parameters. Forty patients with symptomatic MR but no other valvular or coronary disease had valve replacement between 1980 and 1984. Twenty-nine patients (group A) were in New York Heart Association class I or II postoperatively. The remaining patients (group B) were in class III or IV or died. Four preoperative LV function indexes were compared. The means of all indexes in groups A and B were significantly different, but only TVEF completely separated the groups. A TVEF of less than 1.47 uniformly predicted a poor operative outcome.
收缩末期壁应力（ESWS）与容积指数（ESVI）之比已被提议作为慢性二尖瓣反流（MR）中左心室（LV）功能的一个有用指标。然而，尽管该比值反映等长收缩，但MR引起的左心室结构的慢性变化可能会影响其效用。评估了一个纳入射血分数的指标——（TVEF [张力 - 容积射血分数] = ESWS/ESVI×EF）——从而将等长和射血期参数结合起来。1980年至1984年间，40例有症状的MR但无其他瓣膜或冠状动脉疾病的患者接受了瓣膜置换术。29例患者（A组）术后处于纽约心脏协会I级或II级。其余患者（B组）处于III级或IV级或死亡。比较了四个术前左心室功能指标。A组和B组所有指标的均值有显著差异，但只有TVEF能完全区分这两组。TVEF小于1.47一致预示手术结果不佳。
