Zarauza J, Ares M, Vílchez F G, Hernando J P, Gutiérrez B, Figueroa A, Vázquez de Prada J A, Durán R M
Servicio de Cardiología y Hemodinámica, Hospital Universitario Marqués de Valdecilla, Cantabaria, Spain.
Am Heart J. 1998 Dec;136(6):1030-41. doi: 10.1016/s0002-8703(98)70160-7.
Although different Doppler methods have been proposed for the quantification of aortic regurgitation, no study has prospectively compared these methods with each other and their correlation with angiography. The aim of this study was to prospectively analyze the usefulness of different Doppler echocardiography parameters by testing all such parameters in each patient.
Fifty-one patients with aortic regurgitation underwent 2-dimensional and Doppler echocardiographic studies and catheterization. The following Doppler indexes were analyzed and compared with aortography. Color Doppler: (1) jet color height/left ventricular outflow tract height in parasternal long-axis view, and (2) jet color area/left ventricular outflow tract area in short-axis view. Continuous Doppler: (3) regurgitant flow pressure half-time, (4) regurgitant flow time velocity integral (in centimeters), and (5) regurgitant flow time velocity integral (in centimeters)/diastolic period (in milliseconds). Pulsed Doppler in thoracic and abdominal aorta: (6) time velocity integral of diastolic reverse flow (in centimeters), (7) time velocity integral of systolic anterograde flow/integral of diastolic reverse flow, (8) (time velocity integral of diastolic reverse flow/diastolic period) x 100, and (9) diastolic reverse flow duration/diastolic period (as a percentage). We compared these parameters with severity of regurgitation measured by angiography and classified as mild, moderate, or severe.
The most useful parameters were (1) jet color height/left ventricular outflow tract height (correctly classified 42 of 49 patients), (2) (time velocity integral of diastolic reverse flow/diastolic period) x 100 in the thoracic aorta (correctly classified 41 of 46 patients), and (3) (time velocity integral of diastolic reverse flow/diastolic period) x 100 in the abdominal aorta (correctly classified 42 of 49 patients). Sequential integration of these 3 parameters correctly classified 96% of patients (44 of 46 patients) and was achieved in 90% of cases.
An integrated combination of several Doppler parameters can quickly and accurately classify the degree of aortic regurgitation as determined by angiography.
尽管已提出不同的多普勒方法用于定量评估主动脉瓣反流，但尚无研究对这些方法进行前瞻性比较以及它们与血管造影的相关性。本研究的目的是通过在每位患者中测试所有这些参数来前瞻性分析不同多普勒超声心动图参数的实用性。
51例主动脉瓣反流患者接受了二维和多普勒超声心动图检查及心导管检查。分析以下多普勒指标并与主动脉造影进行比较。彩色多普勒：（1）胸骨旁长轴切面射流颜色高度/左心室流出道高度，以及（2）短轴切面射流颜色面积/左心室流出道面积。连续多普勒：（3）反流血流压力半衰期，（4）反流血流时间速度积分（以厘米为单位），以及（5）反流血流时间速度积分（以厘米为单位）/舒张期（以毫秒为单位）。胸主动脉和腹主动脉的脉冲多普勒：（6）舒张期反向血流时间速度积分（以厘米为单位），（7）收缩期正向血流积分/舒张期反向血流积分，（8）（舒张期反向血流时间速度积分/舒张期）×100，以及（9）舒张期反向血流持续时间/舒张期（百分比）。我们将这些参数与通过血管造影测量的反流严重程度进行比较，并分为轻度、中度或重度。
最有用的参数为：（1）射流颜色高度/左心室流出道高度（49例患者中有42例分类正确），（2）胸主动脉中（舒张期反向血流时间速度积分/舒张期）×100（46例患者中有41例分类正确），以及（3）腹主动脉中（舒张期反向血流时间速度积分/舒张期）×100（49例患者中有42例分类正确）。这3个参数的顺序整合正确分类了96%的患者（46例患者中有44例），且在90%的病例中得以实现。
几种多普勒参数的综合组合可以快速、准确地将血管造影确定的主动脉瓣反流程度进行分类。
