Grossmann G, Giesler M, Schmidt A, Kochs M, Wieshammer S, Höher M, Felder C, Hombach V
Department of Internal Medicine, University of Ulm, Germany.
Eur Heart J. 1996 Aug;17(8):1256-64. doi: 10.1093/oxfordjournals.eurheartj.a015044.
In 84 patients mitral regurgitation was quantified by angiography. The mechanism of regurgitation was determined by echocardiography (organic, n = 54, functional, n = 30). The radii of the proximal isovelocity surface areas in the flow convergence region for 28 and 41 cm.s-1 blood flow velocity and the area and length of the regurgitant jet were measured using colour flow Doppler imaging. The radii of the proximal isovelocity surface areas correlated more closely with the angiographic grade than the jet parameters irrespective of the mechanism of regurgitation. In more than 90% of the patients, grades I-II mitral regurgitation were correctly differentiated from grades III-IV by means of the radii of the proximal isovelocity surface areas. Using the jet parameters, the differentiation was correct in 50-90% of the patients depending on the mechanism of regurgitation. The jet area method particularly failed to identify grades III-IV organic mitral regurgitation due to a high prevalence of eccentric jets in these patients. It is concluded that the proximal flow convergence method was suitable for the quantification of mitral regurgitation irrespective of the mechanism of mitral regurgitation. On the other hand, the value of the jet area method depended largely on the regurgitation mechanism.
对84例患者的二尖瓣反流进行了血管造影定量分析。通过超声心动图确定反流机制（器质性，n = 54；功能性，n = 30）。使用彩色多普勒血流成像测量血流会聚区中血流速度为28和41 cm.s-1时近端等速表面积的半径以及反流束的面积和长度。无论反流机制如何，近端等速表面积的半径与血管造影分级的相关性比反流束参数更密切。在超过90%的患者中，通过近端等速表面积的半径能够正确区分I-II级二尖瓣反流与III-IV级二尖瓣反流。根据反流机制，使用反流束参数时，50%-90%的患者能够正确区分。由于这些患者中偏心反流束的发生率较高，反流束面积法尤其难以识别III-IV级器质性二尖瓣反流。结论是，无论二尖瓣反流机制如何，近端血流会聚法都适用于二尖瓣反流的定量分析。另一方面，反流束面积法的价值在很大程度上取决于反流机制。
