| Autor: |
Kamp, Otto, Huitink, Hans, van Eenige, Machiel J., Visser, Cees A., Roos, Jan P. |
| Zdroj: |
Journal of the American Society of Echocardiography; May-June 1992, Vol. 5 Issue: 3 p239-246, 8p |
| Abstrakt: |
To evaluate the relation between left ventricular angiography and pulmonary venous flow velocity in native mitral valve regurgitation, 28 patients with sinus rhythm and valvular and/or coronary artery disease underwent transesophageal echocardiography within 24 hours after cardiac catheterization. Group I consisted of 17 patients, seven patients without (grade 0) and 10 patients with angiographically mild to moderate mitral regurgitation (grades 1 and 2). Group II consisted of 11 patients with angiographically severe mitral regurgitation (grades 3 and 4). Mitral regurgitation by transesophageal echocardiography was evaluated by measuring the regurgitant jet sizes and color-guided pulsed Doppler pulmonary venous flow velocities. Multivariate analysis revealed that the most powerful predictor (p< 0.001) of angiographically severe (grades 3 and 4) mitral regurgitation was reversed systolic flow into the left upper pulmonary vein (sensitivity 82%, specificity 100%, positive predictive value 100%). If this variable was excluded from analysis, jet area and jet length (p< 0.001) were the next best predictors for angiographically severe mitral regurgitation. Mean values of systolic peak pulmonary venous flow velocities were significantly lower in patients from group II, 13.0 ± 11.1 cm/s versus 43.4 ± 20.6 cm/s (group I) with p< 0.005. This finding was also true for systolic time velocity integral, 1.3 ± 1.3 cm (group II) versus 7.8 ± 5.3 cm (group I) with p< 0.005. It is concluded that pulmonary venous flow characteristics can be of additional help to distinguish between angiographic absent or mild-to-moderate mitral regurgitation (grades 0, 1, and 2) and severe mitral regurgitation (grade 3 and 4) in selected patients with sinus rhythm and normal to moderately impaired left ventricular systolic function. |
| Databáze: |
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