Ishii M, Jones M, Shiota T, Yamada I, Sinclair B, Heinrich R S, Yoganathan A P, Sahn D J
Oregon Health Sciences University, Portland, Oregon, USA.
J Am Soc Echocardiogr. 1998 Nov;11(11):1064-71. doi: 10.1016/s0894-7317(98)70158-0.
The purpose of our study was to determine the temporal variability of regurgitant color Doppler jet areas and the width of the color Doppler imaged vena contracta for evaluating the severity of aortic regurgitation.
Twenty-nine hemodynamically different states were obtained pharmacologically in 8 sheep 20 weeks after surgery to produce aortic regurgitation. Aortic regurgitation was quantified by peak and mean regurgitant flow rates, regurgitant stroke volumes, and regurgitant fractions determined using pulmonary and aortic electromagnetic flow probes and meters balanced against each other. The regurgitant jet areas and the widths of color Doppler imaged vena contracta were measured at 4 different times during diastole to determine the temporal variability of this parameter.
When measured at 4 different temporal points in diastole, a significant change was observed in the size of the color Doppler imaged regurgitant jet (percent of difference: from 31.1% to 904%; 233% +/- 245%). Simple linear regression analysis between each color jet area at 4 different periods in diastole and flow meter-based severity of the aortic regurgitation showed only weak correlation (0.23 < r < 0.49). In contrast, for most conditions only a slight change was observed in the width of the color Doppler imaged vena contracta during the diastolic regurgitant period (percent of difference, vena contracta: from 2.4% to 12.9%, 5.8% +/- 3.2%). In addition, for each period the width of the color Doppler imaged vena contracta at the 4 different time periods in diastole correlated quite strongly with volumetric measures of the severity of aortic regurgitation (0.81 < r < 0.90) and with the instantaneous flow rate for the corresponding period (0.85 < r < 0.87).
Color Doppler imaged vena contracta may provide a simple, practical, and accurate method for quantifying aortic regurgitation, even when using a single frame color Doppler flow mapping image.
本研究旨在确定反流彩色多普勒射流面积和彩色多普勒成像缩流宽度随时间的变异性，以评估主动脉瓣反流的严重程度。
在8只绵羊术后20周通过药理学方法获得29种血流动力学不同的状态，以产生主动脉瓣反流。使用相互平衡的肺动脉和主动脉电磁流量探头及测量仪，通过峰值和平均反流流速、反流搏出量以及反流分数对主动脉瓣反流进行量化。在舒张期的4个不同时间点测量反流射流面积和彩色多普勒成像缩流宽度，以确定该参数随时间的变异性。
在舒张期的4个不同时间点进行测量时，彩色多普勒成像反流射流的大小有显著变化（差异百分比：从31.1%至904%；233%±245%）。舒张期4个不同时间段的每个彩色射流面积与基于流量计的主动脉瓣反流严重程度之间的简单线性回归分析显示相关性较弱（0.23＜r＜0.49）。相比之下，在大多数情况下，舒张期反流期间彩色多普勒成像缩流宽度仅有轻微变化（缩流差异百分比：从2.4%至12.9%，5.8%±3.2%）。此外，在舒张期的4个不同时间段，每个时间段彩色多普勒成像缩流宽度与主动脉瓣反流严重程度的容积测量值（0.81＜r＜0.90）以及相应时间段的瞬时流速（0.85＜r＜0.87）均具有很强的相关性。
彩色多普勒成像缩流即使在使用单帧彩色多普勒血流图图像时，也可能为量化主动脉瓣反流提供一种简单、实用且准确的方法。
