Vandenbossche J L, Kramer B L, Massie B M, Morris D L, Karliner J S
J Am Coll Cardiol. 1984 Dec;4(6):1195-206. doi: 10.1016/s0735-1097(84)80138-2.
To evaluate the usefulness of two-dimensional echocardiography in asymptomatic or minimally symptomatic patients with significant aortic regurgitation and left ventricular enlargement, left ventricular size and function measurements obtained by a nongeometric technique, gated blood pool radionuclide angiography, were compared with measurements made by several two-dimensional echocardiographic methods in 20 patients. Left ventricular size was best assessed by an apical biplane modified Simpson's rule algorithm obtained by computer-assisted planimetry. For end-diastolic volume, r = 0.95 and standard error of the estimate = 25 ml; for end-systolic volume, r = 0.94 and standard error of the estimate = 16 ml. A newly introduced simplified two-dimensional method obviating the need for planimetry and using multiple axis measurements yielded satisfactory results, although volumes larger than 300 ml were markedly underestimated. Evaluation of volumes from a single minor axis measured directly from two-dimensional images and M-mode tracings obtained under two-dimensional echocardiographic control was inadequate for clinical use. Ejection fraction was correctly assessed by the modified Simpson's rule method as well as by the simplified two-dimensional method (r = 0.81 to 0.83, standard error of the estimate = 7%). However, when methods without planimetry were further simplified, a satisfactory correlation was no longer obtained. The M-mode approach using a corrected cube formula also provided an accurate estimation of ejection fraction, a finding that is attributed to the absence of regional wall motion abnormalities in this group of patients, the ability to locate the M-mode beam more adequately under two-dimensional control and the persistence of an ellipsoidal configuration and a circular cross section in the left ventricular chamber. The data indicate that two-dimensional echocardiography is a valuable approach to the assessment of left ventricular size and function in these patients. Moreover, this approach provides a practical and convenient way of improving M-mode evaluation of function and of determining left ventricular shape, thus permitting adequate selection of geometric algorithms for volume calculations.
为评估二维超声心动图在无症状或症状轻微但有明显主动脉反流及左心室扩大患者中的应用价值，对20例患者采用非几何技术（门控心血池放射性核素血管造影）获得的左心室大小和功能测量值，与几种二维超声心动图方法所测值进行了比较。左心室大小最好通过计算机辅助平面测量法获得的改良双平面辛普森法则算法进行评估。对于舒张末期容积，r = 0.95，估计标准误 = 25 ml；对于收缩末期容积，r = 0.94，估计标准误 = 16 ml。一种新引入的简化二维方法无需平面测量，采用多轴测量，虽大于300 ml的容积明显低估，但仍取得了满意结果。从二维图像直接测量的单个短轴及在二维超声心动图控制下获得的M型描记图评估容积，临床应用不足。改良辛普森法则方法以及简化二维方法正确评估了射血分数（r = 0.81至0.83，估计标准误 = 7%）。然而，当进一步简化无平面测量的方法时，不再获得满意的相关性。采用校正立方公式的M型方法也能准确估计射血分数，这一发现归因于该组患者无节段性室壁运动异常、在二维控制下能更充分地定位M型波束以及左心室腔呈椭圆形结构和圆形横截面。数据表明二维超声心动图是评估这些患者左心室大小和功能的有价值方法。此外，该方法为改进M型功能评估及确定左心室形状提供了实用且便捷的途径，从而能适当选择几何算法进行容积计算。
