Peltier M, Tribouilloy C, Shen W, Ali Mirode A, Trojette F, Lesbre J P
Service de Cardiologie B, Hôpital Sud, Amiens.
Ann Cardiol Angeiol (Paris). 1995 Sep;44(7):332-8.
The objective of this study was to assess the validity of multidimensional transoesophageal echocardiography (TOE) in the determination of the orificial surface area of aortic stenosis (AS) in 85 patients, using as a reference the surface area calculated on transthoracic ultrasonography (TTU) by applying the continuity principle (n = 75) and/or by haemodynamic studies using Gorlin's formula (n = 40). Planimetry was able to be performed in 78 of the 85 patients (92%). Planimetry was impossible in 7 patients with massive calcification of the aortic orifice (n = 5) or posterior valve (n = 2). The mean value of the selected angle was 45 +/- 13 degrees (0 to 78 degrees). An excellent correlation was observed between aortic surface area (ASA) measured by multidimensional TOE and TTU (r = 0.94; y = 0.90x +/- 0.10; SEE = 0.10 cm2; p < 0.001). Similarly, the ASA on multidimensional TOE was also well correlated with the haemodynamic surface area (r = 0.90, y = 0.94x +/- 0.05; SEE = 0.09 cm2; p < 0.001). The correlations between multidimensional TOE and TTU measurements (n = 26; r = 0.96; y = 0.85 x +/- 0.11; SEE = 0.07 cm2; p < 0.001) and cardiac catheterization (n = 13; r = 0.92; y = 0.77 x +/- 0.7; SEE = 0.09 cm2; p < 0.001) remained satisfactory in patients with associated aortic incompetence. Multidimensional TOE identifies cases of AS with an ASA on TOE or haemodynamic studies less than or equal to 0.75 cm2 with sensitivities of 93% and 92%, respectively, and a specificity of 100%. Overall, multidimensional TOE allows a precise and reliable evaluation of ASA in the great majority of cases of AS.
本研究的目的是评估多维度经食管超声心动图（TOE）在测定85例主动脉瓣狭窄（AS）患者瓣口面积方面的有效性，以经胸超声心动图（TTU）应用连续性原理计算的面积（n = 75）和/或使用戈林公式进行血流动力学研究计算的面积（n = 40）作为参考。85例患者中有78例（92%）能够进行平面测量。7例主动脉瓣口（n = 5）或后叶（n = 2）重度钙化的患者无法进行平面测量。所选角度的平均值为45±13度（0至78度）。多维度TOE测量的主动脉瓣面积（ASA）与TTU测量的结果之间存在极好的相关性（r = 0.94；y = 0.90x±0.10；标准误 = 0.10 cm²；p < 0.001）。同样，多维度TOE测量的ASA与血流动力学瓣面积也具有良好的相关性（r = 0.90，y = 0.94x±0.05；标准误 = 0.09 cm²；p < 0.001）。在合并主动脉瓣关闭不全的患者中，多维度TOE与TTU测量结果（n = 26；r = 0.96；y = 0.85x±0.11；标准误 = 0.07 cm²；p < 0.001）以及心导管检查结果（n = 13；r = 0.92；y = 0.77x±0.7；标准误 = 0.09 cm²；p < 0.001）之间的相关性仍然令人满意。多维度TOE识别出TOE或血流动力学研究中ASA小于或等于0.75 cm²的AS病例，敏感性分别为93%和92%，特异性为100%。总体而言，在绝大多数AS病例中，多维度TOE能够对ASA进行精确可靠的评估。
