Rihal C S, Nishimura R A, Rumberger J A, Tajik A J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J Heart Valve Dis. 1994 Jul;3(4):417-24.
Chronic aortic regurgitation leads to progressive left ventricular dilatation and hypertrophy. It is important to be able to measure these variables for clinical decision making on the timing of aortic valve replacement. M-mode and two-dimensional echocardiography are widely utilized in clinical practice for a qualitative assessment of left ventricular size and function. Recent recommendations have been proposed for the use of quantitative assessment by left ventricular size and left ventricular mass by two-dimensional echocardiography; there has been no study examining the validity of these measurements in patients with aortic regurgitation. The purpose of this study was to prospectively examine the various geometric models of echocardiographically determined left ventricular mass and volumes in patients with chronic aortic regurgitation compared with cine-computed tomographic scanning. Twenty-two patients with chronic aortic regurgitation were prospectively identified and underwent two-dimensional echocardiographic and cine-computed tomographic scanning. M-mode and two-dimensional echocardiographic images were analyzed on an off-line measurement digital system. Seven previously described geometric models were used in this study for quantitative analysis. Both left ventricular mass and left ventricular volume were calculated from real-time ultrafast tomographic scans. Left ventricular mass determinations by two-dimensional echocardiography correlated more than M-mode determinations (r = 0.84 vs. r = 0.75, standard error of the estimate (SEE) = 38 g vs. 139 g). Biplane two-dimensional echocardiography formulas using Simpson's rule construct yielded more accurate values for left ventricular end-diastolic volumes (r = 0.92, SEE = 24 ml) than either the single-plane Simpson's rule (r = 0.58, SEE = 73 mL) or methods using predetermined models of left ventricular shape (r = 0.80, SEE = 38 ml).(ABSTRACT TRUNCATED AT 250 WORDS)
慢性主动脉瓣反流会导致左心室逐渐扩张和肥厚。能够测量这些变量对于决定何时进行主动脉瓣置换的临床决策很重要。M型和二维超声心动图在临床实践中被广泛用于对左心室大小和功能进行定性评估。最近有人建议使用二维超声心动图对左心室大小和左心室质量进行定量评估；但尚无研究检验这些测量方法在主动脉瓣反流患者中的有效性。本研究的目的是前瞻性地研究与电影计算机断层扫描相比，超声心动图测定的慢性主动脉瓣反流患者左心室质量和容积的各种几何模型。前瞻性地确定了22例慢性主动脉瓣反流患者，并对其进行了二维超声心动图和电影计算机断层扫描。在离线测量数字系统上分析M型和二维超声心动图图像。本研究使用了7种先前描述的几何模型进行定量分析。左心室质量和左心室容积均通过实时超速断层扫描计算得出。二维超声心动图测定的左心室质量比M型测定的相关性更强（r = 0.84对r = 0.75，估计标准误差（SEE）= 38 g对139 g）。使用辛普森法则构建的双平面二维超声心动图公式得出的左心室舒张末期容积值（r = 0.92，SEE = 24 ml）比单平面辛普森法则（r = 0.58，SEE = 73 mL）或使用预定左心室形状模型的方法（r = 0.80，SEE = 38 ml）更准确。（摘要截断于250字）
