Rivera J M, Vandervoort P M, Morris E, Weyman A E, Thomas J D
Department of Cardiology, Cleveland Clinic Foundation, Ohio.
J Am Soc Echocardiogr. 1994 Sep-Oct;7(5):480-7. doi: 10.1016/s0894-7317(14)80005-9.
To investigate which factors influence visual evaluation and how accurate it is in patients with valvular insufficiency, 83 patients were studied. All were in sinus rhythm, 43 with mitral and 40 with tricuspid regurgitation. Categoric visual grading (mild, moderate, and severe) was compared with jet area method and regurgitant fraction and the factors that influenced the assigned rank were identified. With jet area method (mean of areas in three planes), the correlation with regurgitant fraction was r = 0.61 for free jets and r = 0.32 for wall jets (overall r = 0.47) in patients with mitral regurgitation, and r = 0.81 and r = 0.46 for free and wall jets, respectively, in patients with tricuspid regurgitation (overall, r = 0.65). With visual grading, the correlation was for free and wall jets, respectively, rho = 0.80 and rho = 0.74 (overall rho = 0.76) in patients with mitral regurgitation, and rho = 0.79 and rho = 0.49 for free and wall jets, respectively (overall rho = 0.62), in patients with tricuspid regurgitation. The jet area parameter found to have the most influence on visual grading was the average area in three planes divided by atrial area, with rho = 0.80 and rho = 0.51 in patients with mitral regurgitation (free and impinging jets respectively) and rho = 0.60 and rho = 0.46 in tricuspid regurgitation. We conclude that visual grading of valvular regurgitant jets correlates well with quantitative measures of valvular incompetence and better than any simple jet area method.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究哪些因素影响瓣膜反流患者的视觉评估以及其准确性如何，对83例患者进行了研究。所有患者均为窦性心律，其中43例有二尖瓣反流，40例有三尖瓣反流。将分类视觉分级（轻度、中度和重度）与射流面积法及反流分数进行比较，并确定影响分级的因素。对于二尖瓣反流患者，采用射流面积法（三个平面面积的平均值），自由射流与反流分数的相关性为r = 0.61，壁面射流为r = 0.32（总体r = 0.47）；对于三尖瓣反流患者，自由射流和壁面射流的相关性分别为r = 0.81和r = 0.46（总体r = 0.65）。对于视觉分级，二尖瓣反流患者自由射流和壁面射流的相关性分别为rho = 0.80和rho = 0.74（总体rho = 0.76），三尖瓣反流患者自由射流和壁面射流的相关性分别为rho = 0.79和rho = 0.49（总体rho = 0.62）。发现对视觉分级影响最大的射流面积参数是三个平面的平均面积除以心房面积，二尖瓣反流患者（自由射流和撞击射流分别）为rho = 0.80和rho = 0.51，三尖瓣反流患者为rho = 0.60和rho = 0.46。我们得出结论，瓣膜反流射流的视觉分级与瓣膜功能不全的定量测量相关性良好，且优于任何简单的射流面积法。（摘要截选至250字）
