Rivera J M, Vandervoort P M, Vazquez de Prada J A, Mele D, Karson T H, Morehead A, Morris E, Weyman A, Thomas J D
Cardiology Department, Cleveland Clinic Foundation, Ohio 44195.
Am J Cardiol. 1993 Dec 1;72(17):1305-9. doi: 10.1016/0002-9149(93)90302-s.
The visual assessment of jet area has become the most common method used in daily clinic practice to evaluate valvular regurgitation. Despite the high prevalence of tricuspid regurgitation, however, few studies have systematically compared TR jet areas with a quantitative standard. To evaluate this, 40 patients in sinus rhythm with tricuspid regurgitation were analyzed: 16 with centrally directed free jets and 24 with impinging wall jets. The size of the maximal planimetered color jet area (cm2) was compared with parameters derived using the pulsed Doppler 2-dimensional echocardiographic method: regurgitant fraction and the flow convergence method (peak flow rate, effective regurgitant orifice area and momentum). Mean tricuspid regurgitant fraction averaged 33 +/- 15%, peak flow rate 76 +/- 54 cm3/s, effective regurgitant orifice area 27 +/- 21 mm2 and momentum 21,717 +/- 15,014 cm4/s2. An average of 4-chamber, and long- and short-axis areas in free jets correlated well with regurgitant fraction (r = 0.81, p < 0.001), better with peak flow rate (r = 0.94, p < 0.001), effective regurgitant orifice (r = 0.92, p < 0.001) and momentum (r = 0.94, p < 0.001). The correlation was worse, but still significant, in wall jets. For the same peak flow rate, wall jets were 75% of the size of a corresponding free jet. Jet area measurement is a good semiquantitative tool to measure tricuspid regurgitation in free jets, which correlates well with regurgitant fraction and better with new parameters available from analysis of the proximal acceleration field. In patients with eccentrically directed wall jets the correlation with planimetered jet area was worse, but still significant.
在日常临床实践中，通过视觉评估射流面积已成为评估瓣膜反流最常用的方法。然而，尽管三尖瓣反流的患病率很高，但很少有研究将三尖瓣反流射流面积与定量标准进行系统比较。为了对此进行评估，分析了40例窦性心律伴三尖瓣反流的患者：16例为中心性自由射流，24例为撞击壁面射流。将最大平面测量的彩色射流面积（cm²）与使用脉冲多普勒二维超声心动图方法得出的参数进行比较：反流分数和血流会聚法（峰值流速、有效反流口面积和动量）。平均三尖瓣反流分数为33±15%，峰值流速为76±54 cm³/s，有效反流口面积为27±21 mm²，动量为21717±15014 cm⁴/s²。自由射流中平均四腔心、长轴和短轴面积与反流分数相关性良好（r = 0.81，p < 0.001），与峰值流速相关性更好（r = 0.94，p < 0.001）、有效反流口（r = 0.92，p < 0.001）和动量（r = 0.94，p < 0.001）。壁面射流中的相关性较差，但仍具有显著性。对于相同的峰值流速，壁面射流的大小是相应自由射流的75%。射流面积测量是测量自由射流中三尖瓣反流的良好半定量工具，它与反流分数相关性良好，与近端加速场分析得出的新参数相关性更好。在伴有偏心壁面射流的患者中，与平面测量射流面积的相关性较差，但仍具有显著性。
