左心室射血分数尚存的低梯度“严重”主动脉瓣狭窄
Cite this article as: Ozkan A. Low gradient "severe" aortic stenosis with preserved left ventricular ejection fraction. Cardiovasc Diagn Ther 2012;2:19- 27. DOI: 10.3978/j.issn.2223-3652.2012.01.01
Review Article

左心室射血分数尚存的低梯度“严重”主动脉瓣狭窄

Alper Ozkan

Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA

Corresponding to:
Alper Ozkan, MD. Department of Cardiovascular Med, Cleveland Clinic, 9500 Euclid Avenue/JJ5-208A, Cleveland, OH 44195, USA.
Tel: 216-445 9101. Email: ozkana@ccf.org.

摘要:

在发达国家,主动脉瓣狭窄(AS)是最常见的心脏瓣膜病,且随着人口的老龄化,其发病率也越来越高。因此,在临床决策中,对病程及其严重性进行准确诊断非常重要。目前的诊疗指南虽然推荐通过经瓣膜阶差、血流最大速度及主动脉瓣区面积来判断疾病的严重程度,但疾病分级不一致仍然是临床中常见的问题。近期研究表明,伴有低流速和/或低梯度的患者主动脉瓣狭窄程度较为严重,且预后较差。目前指南所推荐的诊治模式,可能会导致对症状估计不足,耽误了心脏主动脉换瓣膜(AVR)手术的进行。因此,我们需对有这一富有挑战的临床症状的患者认真进行评估,并制订个体化临床诊疗决策。

Keywords

Aortic stenosis; transvalvular gradients; maximal velocity; aortic valve area

Cardiovasc Diagn Ther 2012;2:19-27. DOI: 10.3978/j.issn.2223-3652.2012.01.01

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