Williams G A, Labovitz A J, Nelson J G, Kennedy H L
Am J Cardiol. 1985 Feb 1;55(4):445-9. doi: 10.1016/0002-9149(85)90391-1.
Fifty-two adults referred for evaluation of aortic stenosis (AS) were studied using continuous-wave and pulsed Doppler echocardiography. Three windows were used to determine which approach (apical, right parasternal or suprasternal) yielded optimal results. Doppler-derived peak aortic valve gradients were compared with the peak gradients measured at cardiac catheterization in 23 patients. High-velocity jets were best recorded from the cardiac apex and less frequently from the right parasternal and suprasternal areas. However, gradients from the right parasternal area correlated best with cardiac catheterization findings, although recordings could be made from this window in only 49% of the patients. Velocities from the suprasternal window were significantly (p less than 0.01) lower than those from the apex or right parasternal areas. Gradient underestimation from the suprasternal window tended to increase with age of the patient (p less than 0.01). When the maximal Doppler derived gradient from any window was compared with catheterization measurements, the correlation coefficient was 0.86. Gradients derived from Doppler velocities accurately predicted severe (more than 50 mm Hg) gradients at catheterization. Thus, Doppler echocardiography is useful in evaluation of AS when several windows are used for optimal assessment of aortic valve gradient.
采用连续波和脉冲多普勒超声心动图对52例因主动脉瓣狭窄（AS）接受评估的成年人进行了研究。使用三个窗口来确定哪种方法（心尖、右胸骨旁或胸骨上）能产生最佳结果。将多普勒得出的主动脉瓣峰值梯度与23例患者心导管检查测得的峰值梯度进行比较。高速血流喷射信号在心尖处记录效果最佳，在右胸骨旁和胸骨上区域记录到的频率较低。然而，右胸骨旁区域得出的梯度与心导管检查结果相关性最佳，尽管只有49%的患者能从此窗口记录到信号。胸骨上窗口测得的流速显著低于心尖或右胸骨旁区域（p<0.01）。胸骨上窗口梯度低估情况往往随患者年龄增加而加重（p<0.01）。将任一窗口通过多普勒得出的最大梯度与心导管检查测量值进行比较时，相关系数为0.86。根据多普勒流速得出的梯度能准确预测心导管检查时的重度（超过50 mmHg）梯度。因此，当使用多个窗口对主动脉瓣梯度进行最佳评估时，多普勒超声心动图对主动脉瓣狭窄的评估很有用。
