左室心肌松弛性对压差半降时间法判定主动脉瓣反流程度的影响

①目的　探讨主动脉瓣反流时左室心肌松弛性对反流的压差半降时间 (PHT)与反流分数 (RF)相关性的影响。②方法　选择 55例主动脉瓣反流病人 ,应用脉冲波多普勒记录二尖瓣口和肺静脉血流频谱 ,测量舒张早期峰值充盈速度 (E)、心房收缩期峰值充盈速度 (A)、E/A比值、舒张早期充盈减速时间 (DECT)、肺静脉血流的收缩波与舒张波的峰值速度比 (S/D)和心房收缩波峰值流速 (Ar)以估测左室心肌松弛性。连续波多普勒记录主动脉瓣反流血流频谱以测量PHT .脉冲波多普勒和二维超声测定左右室每搏量以计算RF .③结果　在全部 55例病人RF与PHT之间存在低相关性 (r=- 0 .31 ,P <0 .0 5) ,在 2 5例无左室心肌肥厚的病人 ,RF与PHT的相关性显著 (r =- 0 .73 ,P <0 .0 0 1 ) ,而在 30例存在左室心肌肥厚的病人 ,RF与PHT之间无相关性。在左室心肌松弛性正常时 ,RF与PHT之间存在显著的相关性 (r =- 0 .67,P <0 .0 0 1 ) ,而在左室心肌松弛性减退时 ,RF与PHT之间相关性消失。④结论　PHT法只适用于估测没有左室心肌松弛性异常的主动脉瓣反流

EFFECT OF LEFT VENTRICULAR RELAXATION ON THE EVALUATION OF AORTIC REGURGITANT SEVERITY BY THE PRESSURE HALF TIME METHOD

Objective\ To investigate the effect of lef t ventricular relaxation on the relation between pressure half time (PHT) and re gurgitant fraction (RF) of aortic regurgitation. \ Methods\ The transmitral flow and pulmonary venous flow were rec orded with pulsed wave Doppler in 55 patients with aortic regurgitation. Left ve ntricular relaxation was assessed with the transmitral early diastolic peak flow velocity (E), late diastolic peak flow velocity (A), E/A ratio, pulmonary veno us systolic to diastolic peak flow velocity ratio (S/D) and atrial reverse peak flow velocity (Ar). PHT was measured with continuous wave Doppler. RF was calcul ated with the difference between right and left ventricular stroke volumes by pu lsed wave Doppler and two dimensional echocardiography. \ Results\ The correlation in 55 patients between RF and PHT was w eak ( r=-0.31, P < 0.05). In 25 patients without left ventricular hypertroph y(LVH), there was a significant correlation between RF and PHT ( r=-0.73, P < 0.001 ), but not in 30 patients with LVH. In patients without abnormal le ft ventricular relaxation(LVR), the relation between RF and PHT was significant ( r=-0.67, P <0.001), whereas in patients with abnormal LVR, no associations between RF and PHT were found. The correlation between RF and PHT disappeared when the LVR reduced.\ Conclusion\ The PHT method is applicable only to aortic regurgit ation without abnormal LVR.