Gosse P, Ansoborlo P, Delest M F, Lemetayer P, Clémenty J
Service Pr Clémenty, hôpital Saint-André, Bordeaux.
Arch Mal Coeur Vaiss. 1997 Jul;90(7):919-25.
Calculation of left ventricular mass by M mode echo is based on the assumption that the geometry of the left ventricle is an ellipsoid, the long axis of which is twice that of its short axis. The hypothesis in not always true and often leads to overestimation of the ventricular mass. The authors propose a method combining M mode data (end diastolic dimension, septal and posterior wall thickness) and 2D measurement of the left ventricular long axis: the left ventricular mass was measured by Devereux's and the authors' methods in 185 hypertensives. The 2D measurement of the long axis (mean: 84.7 mm) was much smaller than twice the short axis (mean: 52.3 mm) and the two measurements were poorly correlated. Measurement of the long axis was reproducible. The two methods of calculation were closely correlated (r = 0.95) but, on average, 23% lower with the authors' method. These results seem to be more closely related to ambulatory blood pressure than those of the classical method. The authors' combined method takes into account the true geometry of the left ventricle better than M mode method alone and avoids overestimation of left ventricular mass and the prevalence of excentric left ventricular hypertrophy in hypertensive patients.
通过M型超声心动图计算左心室质量是基于左心室几何形状为椭球体的假设，其长轴是短轴的两倍。该假设并非总是成立，且常常导致心室质量的高估。作者提出了一种结合M型数据（舒张末期内径、室间隔和后壁厚度）和左心室长轴二维测量的方法：采用Devereux方法和作者的方法对185例高血压患者进行左心室质量测量。长轴的二维测量值（平均：84.7mm）远小于短轴的两倍（平均：52.3mm），且两种测量方法相关性较差。长轴测量具有可重复性。两种计算方法密切相关（r = 0.95），但作者的方法平均比传统方法低23%。这些结果似乎比传统方法与动态血压的关系更为密切。作者的联合方法比单独的M型方法能更好地考虑左心室的真实几何形状，避免高估高血压患者左心室质量和偏心性左心室肥厚的患病率。
