Weyman A E, Feigenbaum H, Hurwitz R A, Girod D A, Dillon J C
Circulation. 1977 May;55(5):773-8. doi: 10.1161/01.cir.55.5.773.
Real-time, cross-sectional echocardiographic studies of the aortic valve were performed in 28 children with congenital valvular aortic stenosis and in 22 normal subjects. The presence of a stenotic valve was indicated by increase in echo production, abnormal motion pattern, and abnormal systolic position of the valve leaflets. Comparison of the maximum aortic cusp separation (MACS) to calculated aortic valve area yielded an r of 0.91. MACS was then expressed as a percentage of aortic root diameter (AOD) to correct for patient size. In normals MACS averaged 72.7% (range 63-92%) of AOD. With mile aortic stenosis MACS averaged 53.1% of AOD (range 42-62%) (P less than 0.001 vs normal). With moderate and severe aortic stenosis MACS averaged 29.9% of AOD (range 20-35%) (P less than 0.001 vs mild AS). Comparing the ratio MACS/AOD to peak systolic gradient yielded an r of 0.88. Further comparing this ratio to calculated aortic valve area yielded an r of 0.80. Cross-sectional echocardiography can detect the presence of aortic stenosis in children and, by comparing the ratio MACS/AOD, can provide information concerning the severity of the stenotic lesion.
对28例先天性瓣膜性主动脉狭窄患儿及22名正常受试者进行了主动脉瓣实时横断面超声心动图研究。回声增强、运动模式异常及瓣叶收缩期位置异常提示存在狭窄瓣膜。最大主动脉瓣叶间距（MACS）与计算得出的主动脉瓣面积比较，相关系数r为0.91。然后将MACS表示为主动脉根部直径（AOD）的百分比，以校正患者体型差异。正常受试者中，MACS平均为AOD的72.7%（范围63 - 92%）。轻度主动脉狭窄时，MACS平均为AOD的53.1%（范围42 - 62%）（与正常相比P<0.001）。中度和重度主动脉狭窄时，MACS平均为AOD的29.9%（范围20 - 35%）（与轻度主动脉狭窄相比P<0.001）。MACS/AOD比值与收缩期峰值压差比较，相关系数r为0.88。该比值与计算得出的主动脉瓣面积进一步比较，相关系数r为0.80。横断面超声心动图可检测儿童主动脉狭窄的存在，并通过比较MACS/AOD比值，提供有关狭窄病变严重程度的信息。
