经食道超声血流汇聚法和压差半降法测定机械二尖瓣有效面积比较研究

Comparison of Proximal Isovelocity Surface Area Method and Pressure Half time Method Using Transesophageal Echocardiography in the Measurement of Mitral Mechanical Prosthetic Orifice Area

目的探讨血流汇聚法（ＰＩＳＡ法）与压差半降法（ＰＨＴ法）测量机械二尖瓣口有效开放面积的准确性及可靠性。方法应用经食道超声心动图，通过ＰＩＳＡ法和ＰＨＴ法测定３１例机械二尖瓣口有效开放面积并作比较分析。结果ＰＩＳＡ法测得的不同型号的机械二尖瓣口有效开放面积较ＰＨＴ法测值重叠少；ＰＩＳＡ法机械二尖瓣口有效开放面积测值在测量者间及测量者内的可重复性优于ＰＨＴ法；心房颤动显著影响ＰＨＴ法测值而不影响ＰＩＳＡ法测值。结论ＰＩＳＡ法测量机械二尖瓣口有效开放面积的准确性及可靠性优于ＰＨＴ法。

Objectives\ This study was designed to examine whether proximal isovelocity surface area method(PISA) is better than pressure half time method(PHT) in the measurement of mitral mechanical prosthetic orifice area(MPOA).\ Methods\ Transesophageal echocardiography(TEE) with continuous Doppler and color Doppler flow imaging was performed in 31 patients who underwent mitral mechanical prosthesis replacement. MPOA was evaluated using PISA and PHT by two examiner.\ Results\ The overlap of MPOA from different size and type of mechanical prostheses measured by PISA was significantly decreased compared with that by PHT,the measurement of MPOA by PHT was significantly influenced by atrial fibrillation,and by PISA was not significantly affected by atrial fibrillation,the inter and intra observer variabilities in measuring MPOA were significantly inhibited by using PISA.\ Conclusion\ PISA is more accurate than PHT in the measurement of MPOA.