Fawzy M E, Halim M, Ziady G, Mercer E, Phillips R, Andaya W
Am J Cardiol. 1987 Mar 1;59(6):643-6. doi: 10.1016/0002-9149(87)91185-4.
Twenty-four patients with porcine bioprostheses in the mitral position were studied by Doppler echocardiography followed by cardiac catheterization within 24 hours. Doppler mean diastolic mitral valve gradient was calculated by a 3-point method and mitral valve area was determined by the pressure half-time method. Data from Doppler echocardiography and cardiac catheterization were compared. There was a strong correlation between Doppler echocardiography and catheterization-determined mean diastolic gradient: r = 0.9, standard error of estimate (SEE) = 1.4 mm/Hg (regression equation y = 0.63x + 1.41), p less than 0.001. There was also a strong correlation between Doppler echocardiography and catheterization-determined mitral valve area: r = 0.86, SEE = 0.18 cm2 (regression equation y = 0.64x + 0.52), p less than 0.001. Fourteen patients whose valvular function was considered normal by clinical evaluation had Doppler-calculated mean diastolic gradients of 4.5 to 9.5 mm Hg (mean 6.5 +/- 1.4); the Doppler-determined valve area was 1.15 to 2.0 cm2 (mean 1.54 +/- 0.3). Ten patients had a malfunctioning bioprosthesis, 7 had severe mitral regurgitation and 3 had stenosis. Valvular malfunction in all 10 patients was detected by Doppler echocardiography and confirmed by catheterization and angiocardiography. Nine patients underwent reoperation. Doppler hemodynamic evaluation of porcine bioprostheses in the mitral position provided noninvasive information comparable to that obtained by cardiac catheterization.
对24例二尖瓣位植入猪生物瓣膜的患者进行了多普勒超声心动图检查，并于24小时内进行了心导管检查。采用三点法计算二尖瓣舒张期平均压差，用压力减半时间法测定二尖瓣面积。比较了多普勒超声心动图和心导管检查的数据。多普勒超声心动图与心导管检查测定的舒张期平均压差之间存在强相关性：r = 0.9，估计标准误差（SEE）= 1.4 mmHg（回归方程y = 0.63x + 1.41），p < 0.001。多普勒超声心动图与心导管检查测定的二尖瓣面积之间也存在强相关性：r = 0.86，SEE = 0.18 cm²（回归方程y = 0.64x + 0.52），p < 0.001。14例经临床评估瓣膜功能正常的患者，多普勒计算的舒张期平均压差为4.5至9.5 mmHg（平均6.5±1.4）；多普勒测定的瓣膜面积为1.15至2.0 cm²（平均1.54±0.3）。10例患者的生物瓣膜功能异常，7例有严重二尖瓣反流，3例有狭窄。所有10例患者的瓣膜功能异常均通过多普勒超声心动图检测到，并经心导管检查和心血管造影证实。9例患者接受了再次手术。二尖瓣位猪生物瓣膜的多普勒血流动力学评估提供了与心导管检查相当的非侵入性信息。
