Rosenblatt A, Clark R, Burgess J, Cohn K
Circulation. 1976 Sep;54(3):509-18. doi: 10.1161/01.cir.54.3.509.
The level of cardiac compensation in valvular disease was studied by relating echocardiographic and cardiac catheterization measurements. Three groups -- compensated, intermediately compensated, and decompensated -- were defined according to the left ventricular angiographic pattern and cardiac output. The echocardiographic ejection indices, percent left ventricular minor diameter shortening, ejection fraction, and fiber shortening rate were significantly higher than normal in compensated mitral regurgitation, lower then normal in compensated aortic stenosis, and within normal limits in compensated aortic insufficiency. In the decomposed state these indices were depressed. Intermediate compensation was best recognized by combining several echocardiographic variables into an echocardiographic score based on multivariate discriminant function analysis. Thus, the compensated volume overload states (aortic and mitral regurgitation) and pressure overload state (aortic stenosis) have separate sets of "normal" echocardiographic values; low ejection indices characterize the decompensated group, while recognition of intermediate compensation requires analysis of multiple echocardiographic variables.
通过关联超声心动图和心导管测量结果，研究了瓣膜病的心脏代偿水平。根据左心室血管造影模式和心输出量定义了三组——代偿组、中度代偿组和失代偿组。在代偿性二尖瓣反流中，超声心动图射血指数、左心室短径缩短百分比、射血分数和纤维缩短率显著高于正常水平；在代偿性主动脉瓣狭窄中低于正常水平；在代偿性主动脉瓣关闭不全中处于正常范围内。在失代偿状态下，这些指标降低。基于多变量判别函数分析，将几个超声心动图变量组合成一个超声心动图评分，最能识别中度代偿。因此，代偿性容量超负荷状态（主动脉瓣和二尖瓣反流）和压力超负荷状态（主动脉瓣狭窄）有各自不同的“正常”超声心动图值集；低射血指数是失代偿组的特征，而识别中度代偿需要分析多个超声心动图变量。
