主动脉瓣狭窄程度影响左房室平面位移而不影响左心室射血分数

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Aims: To examine how left atrioventricular plane displacement(AVPD), a widely used measure of left ventricular(LV) function, is related to presence and degree of aortic stenosis. Methods and results: Cardiac dimensions, LV filling, left A VPD, LV ejection fraction (LVEF), and valve function were assessed by echocardio graphy/Doppler in 182 patients with various cardiac diseases (mean (SD) age 69(1 2) years, 36%women), 49 consecutive with and 133 consecutive without aortic ste nosis. In an analysis of covariance, neither left AVPD nor LVEF was independentl y correlated with the presence of aortic stenosis. However, looking separately a t patients with aortic stenosis, left AVPD (p=0.03) but not LVEF correlated inde pendently with degree of aortic stenosis in multiple linear regression analysis. In patients with aortic stenosis, an abnormal left AVPD had 94%sensitivity and 90%negative predictive value with regard to severe aortic stenosis, compared w ith 56%and 62%, respectively, for LVEF. Conclusion: In patients with cardiac d isease, neither left AVPD nor LVEF correlated independently with presence of aor tic stenosis. However, in patients with aortic stenosis, left AVPD but not LVEF correlated with the degree of aortic valve obstruction and left AVPD but not LVE F had high sensitivity and negative predictive value with regard to severe aorti c stenosis. Compared with LVEF, left AVPD is an earlier and more sensitive marke r of LV haemodynamic load in patients with aortic stenosis. A great majority of atrioventricular plane displacement (AVPD), a widely used measure of left ventricular (LV) function, is related to presence and degree of aortic stenosis. Methods and results: Cardiac dimensions, LV filling, left A VPD, LV ejection fraction (LVEF), and valve function were assessed by echocardio graphy / Doppler in 182 patients with various cardiac diseases (mean (SD) age 69 (12) years, 36% women), 49 consecutive with and 133 consecutive without aortic ste nosis. In an analysis of covariance, neither left AVPD nor LVEF was independentl y correlated with the presence of aortic stenosis. However, looking for at with aortic stenosis, left AVPD (p = 0.03) but not LVEF correlated inde pendently with degree of aortic stenosis in multiple linear regression analysis. In patients with aortic stenosis, an abnormal left AVPD had 94% sensitivity and 90% negative predictive value with regard to severe aortic stenosis, compared w ith 56% and 62% respectively respectively, for LVE F. Conclusion: In patients with cardiac d isease, neither left AVPD nor LVEF correlated independently with presence of aor tic stenosis. However, in patients with aortic stenosis, left AVPD but not LVEF correlated with the degree of aortic valve obstruction and left AVPD but not LVE F had high sensitivity and negative predictive value with regard to severe aorti c stenosis. Compared with LVEF, left AVPD is an earlier and more sensitive marke r of LV haemodynamic load in patients with aortic stenosis.
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