Spinnler M T, Morard J D, Mayor C, Bopp P, Faidutti B, Bloch A
Schweiz Med Wochenschr. 1980 Nov 8;110(45):1681-4.
A first group of 51 patients with pure or predominant mitral stenosis underwent M-mode (M) and two-dimensional (2D) echocardiography and cardiac catheterization (cath). After elimination of 3 incomplete cases, the series consists of 48 patients. 20 later underwent surgery. Quantitative correlations between M and cath are poor (r = 0.34, p less than 0.05); however, correlations between 2D and cath were excellent (r = 0.89, p less than 0.001). There were 4 major discrepancies between 2D and cath: 3 of these patients were operated upon and surgery confirmed 2D mitral valve area in all of them. 2D had served to diagnose all 6 cases of mitral calcifications seen at surgery; however, M provided 1 false negative and 5 false positive results with regard to diagnosis of calcifications. A second group consisted of 18 patients who had undergone mitral commissurotomy, 8 of these had a pre- and postoperative echocardiography. 10 also underwent postoperative cath. M appeared to be unable to predict correctly the presence or absence of a recurrence of mitral stenosis. Quantitative correlations between diastolic slope and mitral valve area at cath were poor. However, excellent correlations were found between 2D and cath, showing that 2D also serves to measure mitral valve area after commissurotomy.
第一组51例单纯或主要为二尖瓣狭窄的患者接受了M型(M)和二维(2D)超声心动图检查以及心导管检查(cath)。剔除3例不完整病例后,该系列包括48例患者。其中20例随后接受了手术。M型检查与心导管检查之间的定量相关性较差(r = 0.34,p < 0.05);然而,二维检查与心导管检查之间的相关性极佳(r = 0.89,p < 0.001)。二维检查与心导管检查之间存在4个主要差异:其中3例患者接受了手术,手术证实所有患者的二维二尖瓣面积均正确。二维检查用于诊断手术中发现的所有6例二尖瓣钙化;然而,M型检查在钙化诊断方面出现了1例假阴性和5例假阳性结果。第二组由18例接受二尖瓣交界切开术的患者组成,其中8例进行了术前和术后超声心动图检查。10例还接受了术后心导管检查。M型检查似乎无法正确预测二尖瓣狭窄是否复发。心导管检查时舒张期斜率与二尖瓣面积之间的定量相关性较差。然而,二维检查与心导管检查之间发现了极佳的相关性,表明二维检查也可用于测量交界切开术后的二尖瓣面积。