Zhang Y, Nitter-Hauge S, Myhre E
Eur Heart J. 1985 Oct;6(10):858-64. doi: 10.1093/oxfordjournals.eurheartj.a061773.
Measurement of the mean pressure gradient provides an important estimation of the severity of mitral stenosis. However, determination of the mean pressure gradient from Doppler recordings has been unsatisfactory using previously described methods. In this study, a new method calculating the mean pressure gradient, the integral method is described. It was developed from mathematical analysis of Doppler velocity curves. Doppler echocardiography and cardiac catheterisation were performed in 23 patients with mitral stenosis to evaluate the accuracy of three current mathematical methods of determining the mean pressure gradient. The mean pressure gradients calculated by the three methods correlated highly with that measured by catheterisation (r = 0.93). However, the mean pressure gradients calculated by the previously described mean velocity square method and the arithmetical average method underestimated significantly that measured by cardiac catheterisation. In contrast, there was no significant difference between the mean pressure gradients calculated by the integral method and measured by cardiac catheterisation. These results confirm the usefulness of Doppler echocardiography for determining the mean pressure gradient in mitral stenosis and demonstrate that among current methods, the integral method provides the most accurate calculations of the mean pressure gradient.
平均压力阶差的测量为二尖瓣狭窄的严重程度提供了重要的评估。然而，使用先前描述的方法从多普勒记录中确定平均压力阶差并不理想。在本研究中，描述了一种计算平均压力阶差的新方法——积分法。它是通过对多普勒速度曲线进行数学分析而开发的。对23例二尖瓣狭窄患者进行了多普勒超声心动图和心导管检查，以评估三种当前确定平均压力阶差的数学方法的准确性。三种方法计算出的平均压力阶差与心导管测量值高度相关（r = 0.93）。然而，先前描述的平均速度平方法和算术平均法计算出的平均压力阶差明显低于心导管测量值。相比之下，积分法计算出的平均压力阶差与心导管测量值之间无显著差异。这些结果证实了多普勒超声心动图在确定二尖瓣狭窄平均压力阶差方面的实用性，并表明在当前方法中，积分法提供了最准确的平均压力阶差计算。
