Kashida M, Kuwako K, Tsuneyoshi H, Takeuchi H, Yamaguchi T, Furuta S, Touda E, Machii K
J Cardiogr. 1985 Sep;15(3):847-56.
The purpose of the present study was to determine the usefulness of two-dimensional echocardiographic measurements of the surgical aortic ring diameters (ARDs) in predicting correct sizes of the prosthetic valves and in determining the mechanisms of aortic regurgitation. Forty patients with aortic regurgitation who underwent prosthetic valve surgery, and 20 normal controls were selected for the study. The 40 patients consisted of 21 with rheumatic aortic regurgitation (RHD group), and 19 with non-rheumatic non-inflammatory aortic regurgitation (non-RHD group). Aortic regurgitation due to annuloaortic ectasia with or without the stigmata of Marfan's syndrome and bicuspid aortic valves were excluded from the non-RHD group. Echocardiographic estimates of the ARDs proved to be useful for predicting prosthetic valve sizes considering the good correlation between the echocardiographic and direct measurements (r = 0.814), despite a slight tendency to echocardiographic underestimation. The ARDs was 24.7 +/- 3 mm in the RHD group, 28.8 +/- 2.9 mm in the non-RHD group and 21.8 +/- 1.7 mm in the normal controls. The ARDs in the RHD group was significantly larger than that of the normal controls (p less than 0.001), and the ARDs of the non-RHD group was significantly larger than that of the RHD group (p less than 0.001). There were loose correlations between the ARDs and left ventricular end-diastolic dimension, and between the ARDs and left ventricular end-systolic dimension in the RHD group (r = 0.549 and r = 0.455, respectively), but there were no correlations between these two parameters in the non-RHD group. In four patients with aortic regurgitation in the non-RHD group, mitral regurgitation coexisted. Both the ARDs and the mitral ring dimension were markedly increased in these patients. It is concluded that in the non-RHD group, marked dilatation of the ARDs appears to be one of the cause of aortic regurgitation.
本研究的目的是确定二维超声心动图测量手术主动脉环直径（ARDs）在预测人工瓣膜正确尺寸以及确定主动脉瓣反流机制方面的实用性。选择40例接受人工瓣膜手术的主动脉瓣反流患者和20例正常对照者进行研究。40例患者中，21例为风湿性主动脉瓣反流（RHD组），19例为非风湿性非炎症性主动脉瓣反流（非RHD组）。非RHD组排除了因主动脉瓣环扩张伴或不伴有马方综合征体征及二叶式主动脉瓣导致的主动脉瓣反流。尽管超声心动图测量有轻微低估的趋势，但考虑到超声心动图测量值与直接测量值之间的良好相关性（r = 0.814），超声心动图对ARDs的估计被证明对预测人工瓣膜尺寸有用。RHD组的ARDs为24.7±3mm，非RHD组为28.8±2.9mm，正常对照组为21.8±1.7mm。RHD组的ARDs显著大于正常对照组（p＜0.001），非RHD组的ARDs显著大于RHD组（p＜0.001）。RHD组中ARDs与左心室舒张末期内径之间以及ARDs与左心室收缩末期内径之间存在松散的相关性（分别为r = 0.549和r = 0.455），但非RHD组中这两个参数之间无相关性。非RHD组中有4例主动脉瓣反流患者合并二尖瓣反流。这些患者的ARDs和二尖瓣环尺寸均明显增大。得出的结论是，在非RHD组中，ARDs的明显扩张似乎是主动脉瓣反流的原因之一。
