Shiota T, Jones M, Yamada I, Heinrich R S, Ishii M, Sinclair B, Yoganathan A P, Sahn D J
Oregon Health Sciences University, Portland, USA.
J Am Coll Cardiol. 1996 Jan;27(1):203-10. doi: 10.1016/0735-1097(95)00392-4.
The aim of the present study was to validate a digital color Doppler-based centerline velocity/distance acceleration profile method for evaluating the severity of aortic regurgitation.
Clinical and in vivo experimental applications of the flow convergence axial centerline velocity/distance profile method have recently been used to estimate regurgitant flow rates and regurgitant volumes in the presence of mitral regurgitation.
In six sheep, a total of 19 hemodynamic states were obtained pharmacologically 14 weeks after the original operation in which a portion of the aortic noncoronary (n = 3) or right coronary (n = 3) leaflet was excised to produce aortic regurgitation. Echocardiographic studies were performed to obtain complete proximal axial flow acceleration velocity/distance profiles during the time of peak regurgitant flow (usually early in diastole) for each hemodynamic state. For each steady state, the severity of aortic regurgitation was assessed by measurement of the magnitude of the regurgitant flow volume/beat, regurgitant fraction and instantaneous regurgitant flow rates determined by using both aortic and pulmonary artery electromagnetic flow probes.
Grade I regurgitation (regurgitant volume/beat < 15 ml, six conditions), grade II regurgitation (regurgitant volume/beat between 16 ml and 30 ml, five conditions) and grade III-IV regurgitation (regurgitant volume/beat > 30 ml, eight conditions) were clearly separated by using the color Doppler centerline velocity/distance profile domain technique. Additionally, an equation for correlating "a" (the coefficient from the multiplicative curve fit for the velocity/distance relation) with the peak regurgitant flow rates (Q [liters/min]) was derived showing a high correlation between calculated peak flow rates by the color Doppler method and the actual peak flow rates (Q = 13a + 1.0, r = 0.95, p < 0.0001, SEE = 0.76 liters/min).
This study, using quantified aortic regurgitation, demonstrates that the flow convergence axial centerline velocity/distance acceleration profile method can be used to evaluate the severity of aortic regurgitation.
本研究旨在验证一种基于数字彩色多普勒的中心线速度/距离加速度剖面法，用于评估主动脉瓣反流的严重程度。
血流会聚轴向中心线速度/距离剖面法在临床和体内实验中的应用，最近已被用于估计存在二尖瓣反流时的反流流速和反流容积。
对6只绵羊在初次手术后14周进行药理学处理，共获得19种血流动力学状态，在初次手术中切除部分主动脉无冠瓣（n = 3）或右冠瓣（n = 3）以产生主动脉瓣反流。进行超声心动图研究，以获取每种血流动力学状态在反流峰值时刻（通常在舒张早期）完整的近端轴向血流加速度速度/距离剖面。对于每个稳态，通过使用主动脉和肺动脉电磁流量探头测量反流容积/搏出量、反流分数和瞬时反流流速的大小，来评估主动脉瓣反流的严重程度。
使用彩色多普勒中心线速度/距离剖面域技术，可清晰区分I级反流（反流容积/搏出量<15 ml，6种情况）、II级反流（反流容积/搏出量在16 ml至30 ml之间，5种情况）和III-IV级反流（反流容积/搏出量>30 ml，8种情况）。此外，推导了一个将“a”（速度/距离关系的乘法曲线拟合系数）与反流峰值流速（Q[升/分钟]）相关联的方程，显示彩色多普勒法计算的峰值流速与实际峰值流速之间具有高度相关性（Q = 13a + 1.0，r = 0.95，p < 0.0001，标准误=0.76升/分钟）。
本研究采用量化的主动脉瓣反流，证明血流会聚轴向中心线速度/距离加速度剖面法可用于评估主动脉瓣反流的严重程度。
