Læknablaðið - 15.11.1988, Síða 44

384
LÆKNABLAÐIÐ
túlka gætilega hjá sérhverjum sjúklingi vegna
mikils breytileika í ósæðarlokuflæði (21). Frekari
þróun Doppler aðferðarinnar mun væntanlega
gera kleift að ákvarða hið eiginlega
ósæðarlokuflatarmál óblóðugt (5, 17, 19).
SUMMARY
Continuous-wave Doppler echocardiography was
performed in 30 consequtive adult patients (18 maies)
with suspected aortic stenosis (AS) within 48 hours prior
to cardiac catheterisation. The mean age was 63 ± 10
years (range 33-75 years); 28 (93%) of the patients were
>50 years. The maximal Doppler and catheterisation
gradients were similar and correlated closely (r = 0.96).
Both these maximal gradients were different from, and
significantly higher than the traditional peak-to-peak
gradients at cátheterisation (p< 0.001). The mean
Doppler and catheterisation gradients showed a close
correlation (r = 0.93), but the mean Doppler gradients
were on the average slightly lower than the mean
catheterisation gradients (Y = 1.03X-6.1, p<0.001). A
curvilinear regression function described the
relationship of both the maximal and the mean Doppler
gradients to the aortic valve area (AVA) indexes (cmVm1)
at catheterisation (r = 0.80 and r = 0.78, respectively).
Thus, significant AS, defined as an AVA index of <0.5
cmVm1, was usually represented by maximal and mean
Doppler gradients of >54 and >33 mmHg,
respectively. However, a considerable range of Doppler
gradients corresponded to a given AVA index,
illustrating the importance of also considering the
influence of transvalvular aortic flow, when assessing
the severity of AS.
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