Nicolosi G L, Atkins F, Dunn M
Chest. 1980 Feb;77(2):147-54. doi: 10.1378/chest.77.2.147.
Fifty-one patients with mitral stenosis were studied by M-mode echocardiograms to verify the possibility of predicting if they will require mitral valve replacement or commissurotomy. Fifteen of 18 patients with heavy calcification and restricted or poor valvular mobility underwent mitral valve replacement. Twelve of 14 patients with normal valve amplitude underwent mitral commissurotomy regardless of the presence of valvular calcification. A newly derived measurement, the MT/ST, which is the ratio between the maximal thickness of the widest echo from the mitral valve and the maximal thickness of the left ventricular margin of the interventricular septum, was used to assess valvular calcification. Values above 1.7 were present only in valves with restricted or poor mobility and indicated mitral valve replacement in 14 of 15 cases. All of the patients undergoing mitral valve replacement who had MT/ST ratios between 1.5 and 1.7 had restricted or poor valvular mobility. Of the patients with MT/ST ratios less than 1.5, ten of 12 with normal valvular amplitude underwent mitral commissurotomy, and four of five with restricted valvular mobility underwent mitral valve replacement. We conclude that echocardiographic assessment of mitral valvular calcification and amplitude is useful in predicting patients who will require mitral valve replacement vs mitral commissurotomy.
对51例二尖瓣狭窄患者进行了M型超声心动图检查，以验证预测他们是否需要二尖瓣置换术或二尖瓣分离术的可能性。18例重度钙化且瓣膜活动受限或较差的患者中有15例接受了二尖瓣置换术。14例瓣膜幅度正常的患者中有12例接受了二尖瓣分离术，无论是否存在瓣膜钙化。一种新推导的测量值MT/ST，即二尖瓣最宽回声的最大厚度与室间隔左心室边缘最大厚度之比，用于评估瓣膜钙化。高于1.7的值仅出现在活动受限或较差的瓣膜中，15例中有14例表明需要二尖瓣置换术。所有MT/ST比值在1.5至1.7之间接受二尖瓣置换术的患者瓣膜活动均受限或较差。在MT/ST比值小于1.5的患者中，12例瓣膜幅度正常的患者中有10例接受了二尖瓣分离术，5例瓣膜活动受限的患者中有4例接受了二尖瓣置换术。我们得出结论，超声心动图对二尖瓣钙化和幅度的评估有助于预测哪些患者需要二尖瓣置换术而非二尖瓣分离术。
