用新的校正近端等速表面积阈值改进三尖瓣反流严重程度评估。

IF 6.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Alexandra S Buta, Luigi P Badano, Marco Penso, Michele Tomaselli, Yuka Kawada, Noela D Radu, Alexandra Clement, Paolo Springhetti, Samantha Fisicaro, Francesca Heilbron, Giorgia Benzoni, Cinzia Pece, Francesco Damiani, Federico Franciosi, Bogdan A Popescu, Denisa Muraru
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引用次数: 0

摘要

目的:研究表明,修正的近端等速表面积(PISA)方法比传统的PISA方法产生更大的反流体积(RegVol)和有效反流孔面积(EROA)值。然而,尚不清楚是否需要新的阈值来校正PISA方法来有效分类继发性三尖瓣反流(STR)的严重程度。本研究试图确定通过修正的PISA方法测量的EROA和RegVol的阈值,用于STR严重程度的三级分类。方法和结果:我们使用三维超声心动图确定容积反流分数(RegFr),计算方法为右(RV)和左(LV)脑卒中容积(SV)之差除以RVSV。共纳入213例孤立性STR患者(78±10岁,64%为女性)。基于RegFr,我们将STR严重程度分为轻度(RegFr< 16%)、中度(RegFr 16-49%)和重度(RegFr> 49%)。采用常规(EROACONV, RegVolCONV)和修正(EROACORR, RegVolCORR) PISA方法测量EROA和RegVol。EROACORR判定轻度、中度和重度STR患者的阈值分别为0.46 cm²;RegVolCORR分别为42 mL。基于EROACORR和RegVolCORR,这些新的阈值预测STR严重程度的准确率分别为99%和94%。结论:修正后的PISA方法必须考虑新的阈值,以改进STR严重程度的分类。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refining tricuspid regurgitation severity assessment with new corrected proximal isovelocity surface area threshold values.

Aims: Research has shown that the corrected proximal isovelocity surface area (PISA) method yields larger values for regurgitant volume (RegVol) and effective regurgitant orifice area (EROA) than conventional PISA method. However, it remains unclear whether new threshold values are needed for the corrected PISA method to effectively categorize the severity of secondary tricuspid regurgitation (STR). This study sought to identify threshold values for EROA and RegVol measured by the corrected PISA method for a three-grade classification of STR severity.

Methods and results: We used three-dimensional echocardiography to determine the volumetric regurgitant fraction (RegFr), calculated as the difference between the right (RV) and left ventricular (LV) stroke volumes (SV) divided by the RVSV. A total of 213 patients (78±10 years; 64% women) with isolated STR were enrolled. Based on RegFr, we classified STR severity into mild (RegFr< 16%), moderate (RegFr 16-49%), and severe (RegFr> 49%) grades. EROA and RegVol were measured using conventional (EROACONV, RegVolCONV) and corrected (EROACORR, RegVolCORR) PISA methods.The threshold values for identifying patients with mild, moderate, and severe STR were <0.22 cm², 0.22-0.46 cm², and >0.46 cm² for EROACORR, respectively; and <18 mL, 18-42 mL, and >42 mL for RegVolCORR, respectively. The accuracy of these new threshold values in predicting STR severity based on RegFr was 99% for EROACORR and 94% for RegVolCORR. These accuracies were significantly higher than those of EROACONV (90%, p<0.001) and RegVolCONV (41%, p<0.001).

Conclusion: New threshold values for the corrected PISA method must be considered to improve the classification of STR severity.

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来源期刊
European Heart Journal - Cardiovascular Imaging
European Heart Journal - Cardiovascular Imaging CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
9.70%
发文量
708
审稿时长
4-8 weeks
期刊介绍: European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology. The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.
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