Soo C S, Ca M, Tay M, Yeoh J K, Sim E, Choo M
Department of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
J Am Soc Echocardiogr. 1994 Mar-Apr;7(2):159-64. doi: 10.1016/s0894-7317(14)80121-1.
We prospectively studied 37 consecutive patients implanted with the Carbomedics prosthetic heart value in the mitral position (without clinical evidence of prosthetic valve dysfunction) with two-dimensional and Doppler echocardiography. The peak mitral prosthetic gradient ranged from 4.60 to 14.63 (mean 8.97 +/- 2.29) mm Hg; mean mitral prosthetic gradient ranged from 1.67 to 6.18 (mean 3.24 +/- 0.95) mm Hg; pressure half-time derived mitral valve area ranged from 1.67 to 5.30 (mean 2.70 +/- 0.80) cm2. These values compare favorably with that of another bileaflet valve (i.e., the St. Jude Medical valve). There was a wide overlap in peak and mean transmitral gradients, even with the valves of the same size, with a significant but weak inverse relationship between peak mitral gradients and valve size (p = 0.03, r = -0.36). The performance index showed a smaller range of values, again with a significant but weak inverse relationship with valve size (p = 0.001, r = -0.54). The inverse relationship between valve size and peak mitral gradient and performance index should be borne in mind when analyzing Doppler hemodynamic data.
我们前瞻性地研究了37例连续在二尖瓣位置植入Carbomedics人工心脏瓣膜的患者（无人工瓣膜功能障碍的临床证据），采用二维和多普勒超声心动图进行检查。二尖瓣人工瓣膜峰值梯度范围为4.60至14.63（平均8.97±2.29）mmHg；二尖瓣人工瓣膜平均梯度范围为1.67至6.18（平均3.24±0.95）mmHg；压力减半时间推导的二尖瓣面积范围为1.67至5.30（平均2.70±0.80）cm²。这些值与另一种双叶瓣膜（即圣犹达医疗瓣膜）相比具有优势。即使是相同尺寸的瓣膜，峰值和平均跨二尖瓣梯度也有很大重叠，二尖瓣峰值梯度与瓣膜尺寸之间存在显著但较弱的负相关关系（p = 0.03，r = -0.36）。性能指数显示的值范围较小，同样与瓣膜尺寸存在显著但较弱的负相关关系（p = 0.001，r = -0.54）。在分析多普勒血流动力学数据时，应牢记瓣膜尺寸与二尖瓣峰值梯度和性能指数之间的负相关关系。
