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美国卫生研究院文献>British Heart Journal
>Continuous wave Doppler echocardiography and coarctation of the aorta: gradients and flow patterns in the assessment of severity.
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Continuous wave Doppler echocardiography and coarctation of the aorta: gradients and flow patterns in the assessment of severity.
Indices of the severity of coarctation derived from non-invasive Doppler echocardiography were compared with measurements derived from cardiac catheterisation and angiography. In 24 Doppler studies from 17 children instantaneous peak systolic and diastolic gradients and time to half peak systolic and diastolic velocities were compared with the ratio of the coarctation diameter to the diameter of descending aorta at the level of diaphragm obtained from angiographic systolic frames of the aorta. A high peak systolic gradient (greater than 40 mm Hg) or long time to half peak diastolic velocity (greater than 100 ms) (that is, maintenance of flow in diastole) were both highly specific (100%) in detecting coarctation of the aorta where the angiographic ratio was less than or equal to 0.5. Diastolic measurements, however, were more sensitive (79% both for peak diastolic gradient and for time to half peak diastolic velocity) than systolic (57% for peak systolic gradient and 64% for time to half peak systolic velocity). Even higher sensitivity (93%) was obtained when the peak systolic gradient was greater than 40 mm Hg or the time to half peak diastolic velocity was greater than 100 ms. Examination by continuous wave Doppler echocardiography is an effective non-invasive method of assessing the severity of coarctation of the aorta, particularly when systolic and diastolic events are considered together. This approach overcomes the relatively low sensitivity of peak systolic gradient alone.
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机译:将无创多普勒超声心动图得出的缩窄严重程度指标与心脏导管插入术和血管造影得出的测量结果进行比较。在来自17名儿童的24个多普勒研究中,比较了收缩压和舒张速度达到峰值的一半的时间,以及收缩直径与降主动脉直径的比值与从主动脉血管造影收缩框架获得的横diaphragm膜水平的比率。高峰值收缩压梯度(大于40 mm Hg)或长时间到半峰值舒张速度(大于100 ms)(即维持舒张期血流)在检测主动脉缩窄方面都具有很高的特异性(100%)血管造影率小于或等于0.5。然而,舒张压测量值(舒张压峰值和到达舒张压半峰的时间都为79%)比收缩压(峰值收缩压为57%,收缩压半峰时间为64%)更敏感。当峰值收缩压梯度大于40 mm Hg或达到最大舒张半峰速度的时间大于100 ms时,可获得更高的灵敏度(93%)。连续波多普勒超声心动图检查是评估主动脉缩窄严重程度的有效非侵入性方法,尤其是在同时考虑收缩和舒张事件的情况下。这种方法克服了仅峰值收缩压梯度的较低灵敏度。
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