彩色多普勒反流束面积评估偏心性二尖瓣反流：一项二尖瓣反流定量的动物研究

Color Doppler regurgitant jet area for evaluating eccentric mitral regurgitation: an animal study with quantified mitral regurgitation.

作者信息

Shiota T, Jones M, Teien D, Yamada I, Passafini A, Knudson O, Sahn D J

机构信息

Clinical Care Center for Congenital Heart Disease, Oregon Health Sciences University, Portland 97201-3181.

出版信息

J Am Coll Cardiol. 1994 Sep;24(3):813-9. doi: 10.1016/0735-1097(94)90033-7.

DOI:10.1016/0735-1097(94)90033-7

PMID:8077557

Abstract

OBJECTIVES

The purpose of the present study was to rigorously evaluate the accuracy of the color Doppler jet area planimetry method for quantifying chronic mitral regurgitation.

BACKGROUND

Although the color Doppler jet area has been widely used clinically for evaluating the severity of mitral regurgitation, there have been no studies comparing the color jet area with a strictly quantifiable reference standard for determining regurgitant volume.

METHODS

In six sheep with surgically produced chronic mitral regurgitation, 24 hemodynamically different states were obtained. Maximal color Doppler jet area for each state was obtained with a Vingmed 750. Image data were directly transferred in digital format to a microcomputer. Mitral regurgitation was quantified by the peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions determined using mitral and aortic electromagnetic flow probes.

RESULTS

Mean regurgitant volumes varied from 0.19 to 2.4 liters/min (mean [+/- SD] 1.2 +/- 0.59), regurgitant stroke volumes from 1.8 to 29 ml/beat (mean 11 +/- 6.2), peak regurgitant volumes from 1.0 to 8.1 liters/min (mean 3.5 +/- 2.1) and regurgitant fractions from 8.0% to 54% (mean 29 +/- 12%). Twenty-two of 24 jets were eccentric. Simple linear regression analysis between maximal color jet areas and peak and mean regurgitant flow rates, regurgitant stroke volumes and regurgitant fractions showed correlation, with r = 0.68 (SEE 0.64 cm2), r = 0.63 (SEE 0.67 cm2), r = 0.63 (SEE 0.67 cm2) and r = 0.58 (SEE 0.71 cm2), respectively. Univariate regression comparing regurgitant jet area with cardiac output, stroke volume, systolic left ventricular pressure, pressure gradient, left ventricular/left atrial pressure gradient, left atrial mean pressure, left atrial v wave pressure, systemic vascular resistance and maximal jet velocity showed poor correlation (0.08 < r < 0.53, SEE > 0.76 cm2).

CONCLUSIONS

This study demonstrates that color Doppler jet area has limited use for evaluating the severity of mitral regurgitation with eccentric jets.

摘要

目的

本研究旨在严格评估彩色多普勒射流面积平面测量法对慢性二尖瓣反流进行定量分析的准确性。

背景

尽管彩色多普勒射流面积已在临床上广泛用于评估二尖瓣反流的严重程度，但尚无研究将彩色射流面积与用于确定反流容积的严格可量化参考标准进行比较。

方法

在6只通过手术造成慢性二尖瓣反流的绵羊身上，获得了24种血流动力学不同的状态。使用Vingmed 750获取每种状态下的最大彩色多普勒射流面积。图像数据以数字格式直接传输到微型计算机。使用二尖瓣和主动脉电磁流量探头，通过反流峰值流速、平均反流流速、反流搏出量和反流分数对二尖瓣反流进行定量分析。

结果

平均反流容积在0.19至2.4升/分钟之间（平均[±标准差]为1.2±0.59），反流搏出量在1.8至29毫升/搏之间（平均为11±6.2），反流峰值流速在1.0至8.1升/分钟之间（平均为3.5±2.1），反流分数在8.0%至54%之间（平均为29±12%）。24个射流中有22个是偏心的。最大彩色射流面积与反流峰值流速、平均反流流速、反流搏出量和反流分数之间的简单线性回归分析显示具有相关性，r分别为0.68（估计标准误差为0.64平方厘米）、0.63（估计标准误差为0.67平方厘米）、0.63（估计标准误差为0.67平方厘米）和0.58（估计标准误差为0.71平方厘米）。将反流射流面积与心输出量‘、搏出量、左心室收缩压、压力阶差、左心室/左心房压力阶差、左心房平均压力、左心房v波压力、体循环血管阻力和最大射流速度进行单变量回归分析，结果显示相关性较差（0.08 < r < 0.53，估计标准误差>0.76平方厘米）。