Gentile R, Pearlman S A, Arata L, Stevenson S G, Avella A, Vitarelli A
G Ital Cardiol. 1984 Mar;14(3):175-80.
The value of echocardiographic measurement of left ventricle volume and ejection fraction and of mitral valve area in patients with mitral stenosis has been assessed. All patients referred because of mitral stenosis have been studied by M-mode and two-dimensional echocardiography, by right and left heart catheterization, ventriculography and selective coronary angiography. Patients with other congenital or acquired heart disease or with coronary artery disease were excluded from this study. The selection lead to a series of 39 pts, all with a typical history of Rheumatic Fever: all these pts were divided in three groups according to the degree of mitral stenosis, classified as "mild", if valvular area was greater than 1.8 cm2 (8 pts), "moderate" between 1-1.8 cm2 (15 pts) and "severe" if valvular areas was less than 1 cm2 (16 pts). In all groups echocardiography underestimated left ventricular volumes as well as stroke volumes. Statistical correlation has not been excellent: the best result was again obtained in the calculation of ejection fraction (r = 0.91, P less than 0.001), confirming our previous results in a group of patients with mitral regurgitation. Cross-sectional two-dimensional echocardiography has confirmed, furthermore, as a sensitive and suitable procedure in assessing the mitral valve area (r = 0,87 P less than 0.001); at our experience echocardiography under-estimate mitral area in the cases of severe mitral stenosis.
已对二尖瓣狭窄患者超声心动图测量左心室容积、射血分数及二尖瓣面积的价值进行了评估。所有因二尖瓣狭窄前来就诊的患者均接受了M型和二维超声心动图检查、左右心导管检查、心室造影及选择性冠状动脉造影。本研究排除了患有其他先天性或后天性心脏病或冠状动脉疾病的患者。经过筛选，形成了一个由39例患者组成的系列，所有患者均有典型的风湿热病史：所有这些患者根据二尖瓣狭窄程度分为三组，瓣膜面积大于1.8 cm²为“轻度”（8例），1 - 1.8 cm²为“中度”（15例），瓣膜面积小于1 cm²为“重度”（16例）。在所有组中，超声心动图均低估了左心室容积及每搏量。统计相关性并不理想：在射血分数计算中再次获得了最佳结果（r = 0.91，P < 0.001），这证实了我们之前在一组二尖瓣反流患者中的研究结果。此外，二维超声心动图已证实是评估二尖瓣面积的一种敏感且合适的方法（r = 0.87，P < 0.001）；根据我们的经验，在严重二尖瓣狭窄病例中，超声心动图会低估二尖瓣面积。
