Sukernik M R, West O, Lawal O, Chittivelu B, Henderson R, Sherzoy A A, Vanderbush E J, Francis C K
Division of Cardiology, Harlem Hospital Center, College of Physicians & Surgeons, Columbia University, New York, New York, USA.
Am J Cardiol. 1996 Jan 15;77(2):184-6. doi: 10.1016/s0002-9149(96)90593-7.
To identify the hemodynamic association of spontaneous echo contrast (SEC) in the descending aorta (DA), we measured aortic flow parameters in 102 consecutive patients studied with transesophageal echocardiography. SEC in the DA was identified in 19 of 102 patients (19%). Patients with SEC in the DA were older (67 +/- 9 vs 57 +/- 17 years; p = 0.001), had a higher proportion of chronic atrial arrhythmia (13 of 19 vs 11 of 83; p = 0.000001), and had a higher frequency of decreased left ventricular performance (10 of 19 vs 19 of 83; p = 0.01). Patients with SEC in the DA had larger aortic diameters (2.9 +/- 0.5 vs 2.3 +/- 0.4 cm; p = 0.0001), lower maximal velocity in the DA (42.6 +/- 12.8 vs 75.6 +/- 34.4 cm/s; p = 0.0001), and lower maximal shear rate (61.6 +/- 20.3 vs 139.9 +/- 78.8 s-1; p = 0.0001). There was no difference in volumetric flow in the DA between groups. In multivariate analysis, only arrhythmia (p = 0.008) and maximal shear rate (p = 0.002) were identified as significant independent predictors of SEC in the DA. We conclude that SEC in the DA is related to chronic atrial arrhythmia and shear rate but not to volumetric flow.
为了确定降主动脉（DA）内自发回声造影（SEC）的血流动力学关联，我们对102例连续接受经食管超声心动图检查的患者测量了主动脉血流参数。102例患者中有19例（19%）在DA内发现SEC。DA内有SEC的患者年龄更大（67±9岁 vs 57±17岁；p = 0.001），慢性房性心律失常的比例更高（19例中的13例 vs 83例中的11例；p = 0.000001），左心室功能下降的频率更高（19例中的10例 vs 83例中的19例；p = 0.01）。DA内有SEC的患者主动脉直径更大（2.9±0.5 cm vs 2.3±0.4 cm；p = 0.0001），DA内的最大流速更低（42.6±12.8 cm/s vs 75.6±34.4 cm/s；p = 0.0001），最大剪切率更低（61.6±20.3 s-1 vs 139.9±78.8 s-1；p = 0.0001）。两组间DA的容积流量无差异。在多变量分析中，只有心律失常（p = 0.008）和最大剪切率（p = 0.002）被确定为DA内SEC的显著独立预测因素。我们得出结论，DA内的SEC与慢性房性心律失常和剪切率有关，而与容积流量无关。
