Grossmann G, Giesler M, Stein M, Kochs M, Höher M, Hombach V
Department of Internal Medicine, University of Ulm, Germany.
Int J Cardiol. 1998 Oct 30;66(3):299-307. doi: 10.1016/s0167-5273(98)00224-1.
In patients with mitral (n=77: organic=49, functional=28) and tricuspid regurgitation (n=55: functional=54) quantified by angiography, the temporal variation of the proximal flow convergence region throughout systole was assessed by colour Doppler M-Mode, and peak and mean radius of the proximal isovelocity surface area for 28 cm/s blood flow velocity were measured. Additionally, the peak radius derived from two-dimensional colour Doppler was obtained. About 50% of the patients with mitral and tricuspid regurgitation showed a typical temporal variation of the flow convergence region related to the mechanism of regurgitation. The different proximal isovelocity surface area radii were similarly correlated to the angiographic grade in mitral and tricuspid regurgitation (rank correlation coefficients 0.55-0.89) and they differentiated mild to moderate (grade < or =II) from severe (grade > or =III) mitral and tricuspid regurgitation with comparable accuracy (82-96%). However, moderate mitral regurgitation due to leaflet prolapse in two patients was correctly classified by the mean M-mode radius and overestimated by both peak radii. Only half of the patients showed a typical variation of the flow convergence region related to the mechanism of regurgitation. The different proximal isovelocity surface area radii were suitable to quantify mitral and tricuspid regurgitation in most patients. However, in mitral regurgitation due to leaflet prolapse the use of the mean M-mode radius may avoid overestimation.
在通过血管造影术量化二尖瓣反流（n = 77：器质性 = 49，功能性 = 28）和三尖瓣反流（n = 55：功能性 = 54）的患者中，通过彩色多普勒M型模式评估整个收缩期近端血流汇聚区的时间变化，并测量血流速度为28 cm/s时近端等速表面积的峰值和平均半径。此外，还获得了二维彩色多普勒得出的峰值半径。约50%的二尖瓣和三尖瓣反流患者显示出与反流机制相关的血流汇聚区典型时间变化。二尖瓣和三尖瓣反流中不同的近端等速表面积半径与血管造影分级同样相关（等级相关系数0.55 - 0.89），并且它们以相当的准确性（82 - 96%）区分轻度至中度（≤II级）与重度（≥III级）二尖瓣和三尖瓣反流。然而，两名因瓣叶脱垂导致的中度二尖瓣反流患者，通过平均M型模式半径正确分类，但峰值半径均高估。只有一半的患者显示出与反流机制相关的血流汇聚区典型变化。不同的近端等速表面积半径适用于大多数患者二尖瓣和三尖瓣反流的量化。然而，在因瓣叶脱垂导致的二尖瓣反流中，使用平均M型模式半径可能避免高估。
