Cohen G I, Duffy C I, Klein A L, Miller D P, Cosgrove D M, Stewart W J
Department of Cardiology, Sinai Hospital, Detroit, MI 48235, USA.
J Am Soc Echocardiogr. 1996 Jul-Aug;9(4):508-15. doi: 10.1016/s0894-7317(96)90122-4.
The character of the color flow Doppler jet provides information on the mechanism and pathologic elements of valve dysfunction. This has been useful in the evaluation of mitral regurgitation, a repairable problem, but has not been described comprehensively for the aortic valve. The purpose of our study was to correlate the color flow Doppler characteristics of the aortic regurgitant jet and two-dimensional echocardiographic findings of valve mobility with surgical pathology. Prepump intraoperative echocardiography and color flow Doppler echocardiography were performed on 124 patients with aortic regurgitation and used to categorize leaflet motion as excessive, restricted, or normal, jet direction as eccentric or central, and jet origin between the cusps as eccentric, central, or diffuse. Bicuspid disease and tricuspid aortic valve prolapse were associated with excessive valve mobility and eccentric jet direction and origin. Conversely, annular dilation, rheumatic disease, sclerosis, and perforation were associated with normal or reduced cusp mobility and a central jet direction and origin (p = 0.001). Overall, an eccentric jet direction occurred in 69% of patients with excessive cusp mobility, whereas 71% of patients with normal or reduced cusp mobility had a central jet (p = 0.001). Therefore color flow Doppler determination of the eccentricity of regurgitant jet direction and origin is useful in predicting the mechanism and disease of aortic valve dysfunction. These observations may suggest the presence of prolapse and thus the potential for aortic valve repair.
彩色血流多普勒喷射的特征提供了有关瓣膜功能障碍的机制和病理因素的信息。这在二尖瓣反流（一种可修复的问题）的评估中很有用，但尚未对主动脉瓣进行全面描述。我们研究的目的是将主动脉反流喷射的彩色血流多普勒特征与瓣膜活动度的二维超声心动图结果与手术病理学相关联。对124例主动脉反流患者进行了预泵入术中心脏超声心动图和彩色血流多普勒超声心动图检查，并用于将瓣叶运动分类为过度、受限或正常，喷射方向分类为偏心或中心，以及瓣叶间喷射起源分类为偏心、中心或弥漫性。二叶式病变和三尖瓣主动脉瓣脱垂与瓣叶活动过度、偏心喷射方向和起源有关。相反，瓣环扩张、风湿性疾病、硬化和穿孔与瓣叶活动度正常或降低以及中心喷射方向和起源有关（p = 0.001）。总体而言，69%瓣叶活动过度的患者出现偏心喷射方向，而71%瓣叶活动度正常或降低的患者有中心喷射（p = 0.001）。因此，彩色血流多普勒测定反流喷射方向和起源的偏心度有助于预测主动脉瓣功能障碍的机制和疾病。这些观察结果可能提示脱垂的存在，从而提示主动脉瓣修复的可能性。
