Veyrat C, Sebaoun G, Gramage J Y, Dumora P, Gourtchiglouian C, Kalmanson D
Arch Mal Coeur Vaiss. 1985 Oct;78(10):1473-83.
The authors compared the data obtained with pulsed (pulsed Doppler-Scanner 3 MHz) and continuous wava Doppler (2.5 MHz), with that obtained by catheterisation in the evaluation of severity of valvular stenoses. The study material comprised 10 healthy subjects and 45 patients with mitral (21) and aortic (24 cases) stenosis, all of whom underwent catheterisation. Stenosis was graded in 3 degrees of increasing severity based on the catheter data. In addition, we studied the correlations between the transvalvular mitral and aortic pressure gradients, calculated by continuous Doppler and catheterisation, and the time of half decrease of flow measured by continuous Doppler and the mitral surface area calculated by catheterisation. No abnormality Was noted in the healthy patients. The jet of the aortic stenosis could not be recorded by continuous Doppler in 8 cases and aortic flow could not be recorded in 1 case with pulsed Doppler. The linear correlation with continuous Doppler was 0.96 (aortic transvalvular gradient for the 16 jets obtained), 0.81 (mitral transvalvular gradient), and 0.80 (time of half decrease of flow and mitral surface area calculated with catheterisation). The comparative study of the degree of severity gives the following percentages of success: mitral stenosis, 85% (pulsed Doppler) vs 71% (continuous Doppler) for mitral stenoses; aortic stenoses 83% (pulsed Doppler) vs 58% (continuous Doppler). In the 16 cases where the aortic jet was recorded properly this percentage was 87% (continuous Doppler) vs 81% (pulsed Doppler). In conclusion, the advantage of continuous Doppler over pulsed Doppler is that it provides quantitative parameters in correlation with catheter data. It is mainly used for evaluating recording the jet should significantly suggest that in elderly patients a systematic right parasternal approach in the jet should significantly reduce the failure rate observed in this study. It is of more limited value in mitral stenoses where pulsed Doppler gives more detailed information about the flow through the mitral valve. This, and the fact that pulsed Doppler can also be used for assession of aortic stenoses, illustrate the complementary nature of the two technique which should always be used together.
作者比较了使用脉冲式（脉冲多普勒扫描仪3MHz）和连续波多普勒（2.5MHz）获得的数据，以及通过心导管检查获得的数据，以评估瓣膜狭窄的严重程度。研究材料包括10名健康受试者和45例二尖瓣（21例）和主动脉瓣（24例）狭窄患者，所有患者均接受了心导管检查。根据心导管数据，将狭窄分为严重程度递增的3级。此外，我们研究了通过连续多普勒和心导管检查计算出的跨二尖瓣和主动脉瓣压力梯度之间的相关性，以及通过连续多普勒测量的血流减半时间和通过心导管检查计算出的二尖瓣面积之间的相关性。健康患者未发现异常。8例主动脉瓣狭窄患者的射流无法通过连续多普勒记录，1例患者的主动脉血流无法通过脉冲多普勒记录。与连续多普勒的线性相关性分别为0.96（16例获得的主动脉跨瓣梯度）、0.81（二尖瓣跨瓣梯度）和0.80（血流减半时间与心导管检查计算出的二尖瓣面积）。严重程度比较研究的成功率如下：二尖瓣狭窄，二尖瓣狭窄时脉冲多普勒为85%，连续多普勒为71%；主动脉瓣狭窄，脉冲多普勒为83%，连续多普勒为58%。在16例主动脉射流记录正确的病例中，该百分比连续多普勒为87%，脉冲多普勒为81%。总之，连续多普勒相对于脉冲多普勒的优势在于它能提供与心导管数据相关的定量参数。它主要用于评估记录射流，这应显著表明，在老年患者中，在射流处采用系统的右胸骨旁入路应能显著降低本研究中观察到的失败率。在二尖瓣狭窄中，其价值较为有限，因为脉冲多普勒能提供有关通过二尖瓣血流的更详细信息。这一点，以及脉冲多普勒也可用于评估主动脉瓣狭窄的事实，说明了这两种技术的互补性，应始终一起使用。
