Oku K, Utsunomiya T, Mori H, Yamachika S, Yano K
Third Department of Internal Medicine, Nagasaki University, Japan.
Jpn Heart J. 1997 Nov;38(6):811-9. doi: 10.1536/ihj.38.811.
Two-dimensional echocardiographic (2-D) planimetry and the Doppler pressure half-time (PHT) method have been used to estimate mitral valve area (MVA) in patients with mitral stenosis (MS). Recently, the proximal isovelocity surface area (PISA) method has been shown to be accurate for calculating MVA. The purpose of this study was to compare the PISA method with previous methods. Thirty patients with MS were studied; 17 had pure MS, 4 combined mild MR, 6 combined mild AR, and 3 combined MR and AR. Color Doppler flow mapping was performed at an aliasing (blue-red interface) velocity of 14 cm/sec using the zero-baseline shift. MVA was calculated as 2 x 3.14 x R2 x 14 x (theta/180) / PFV, where R is the distance from aliasing to orifice, 14 is the aliasing velocity, theta is the internal angle of the mitral valve, and PFV is the peak flow velocity at the mitral orifice. MVA was also calculated using the 2-D and PHT methods, and compared with the PISA method. MVA calculated using the PISA method correlated well with the 2-D (r=0.90, p < 0.01, SEE = 0.18 cm2) and PHT methods (r=0.82, p < 0.01, SEE = 0.24 cm2). Compared with the 2-D method, the standard error of the estimate of the PISA method was - 0.14+/-0.18 cm2 and the percent error was -10.4+/-18.9%. Compared with the PHT method, the standard error of the estimate of the PISA method was + 0.01+/-0.24 cm2 and the percent error was +3.4+/-34.6%. MVA calculated using the PISA method correlated well with the 2-D and PHT methods in patients with pure MS or with MS combined mild regurgitation. The PISA method may be useful for calculating MVA as an alternative method.
二维超声心动图（2-D）平面测量法和多普勒压力减半时间（PHT）法已被用于评估二尖瓣狭窄（MS）患者的二尖瓣面积（MVA）。最近，近端等速表面积（PISA）法已被证明在计算MVA方面是准确的。本研究的目的是将PISA法与先前的方法进行比较。对30例MS患者进行了研究；其中17例为单纯MS，4例合并轻度二尖瓣反流（MR），6例合并轻度主动脉反流（AR），3例合并MR和AR。使用零基线偏移，以14 cm/秒的混叠（蓝-红界面）速度进行彩色多普勒血流成像。MVA的计算方法为2×3.14×R2×14×（θ/180）/PFV，其中R为从混叠处到瓣口的距离，14为混叠速度，θ为二尖瓣的内角，PFV为二尖瓣瓣口处的峰值流速。还使用2-D法和PHT法计算MVA，并与PISA法进行比较。使用PISA法计算的MVA与2-D法（r = 0.90，p < 0.01，标准估计误差[SEE] = 0.18 cm2）和PHT法（r = 0.82，p < 0.01，SEE = 0.24 cm2）相关性良好。与2-D法相比，PISA法的估计标准误差为-0.14±0.18 cm2，百分比误差为-10.4±18.9%。与PHT法相比，PISA法的估计标准误差为+0.01±0.24 cm2，百分比误差为+3.4±34.6%。在单纯MS或合并轻度反流的MS患者中，使用PISA法计算的MVA与2-D法和PHT法相关性良好。PISA法作为一种替代方法，可能有助于计算MVA。
