Color M-Mode Mitral Propagation Velocity in Patients with Mitral Stenosis

Öz

Amaç: Bu çalışmanın amacı mitral darlığı ciddiyetini belirlemede yeni bir yöntem olarak mitral M-mod akım yayılma hızı (Vp) kullanımını değerlendirmekti.  

Yöntem: Prospektif olarak mitral darlığı  (MD) olan 65 hasta incelendi. Hastalarda MD planimetri, PHT ve ortalama gradiyent kullanılarak ayrı ayrı derecelendirildi. Kardiyak kateterizasyon yapılmadığından referans ölçüm olarak kabul edilen planimetriye göre 25 hastada hafif MD (%38.5), 27 hastada orta MD (%41.5), 13 hastada ciddi MD (%20) mevcuttu. Vp ilk aliasing velosite ile mavi jet eğimini ölçerek elde edildi.

Bulgular: Hafif MD’de ortalama Vp 43.3+/-9.05 cm/s, orta MD’de Vp 52.09+/-9.22 cm/s, ciddi MD’de ise Vp 73.93+/- 15.75 cm/s olarak sap- tandı (p1-2:0.002 (hafif ile orta MD) p2-3<0.001 (orta ile ciddi MD) p1-3<0.001 (hafif ile ciddi MD)), yani planimetrik kapak alanı cid- diyeti ile Vp arasında istatistiksel anlamlı korelasyon saptandı. Benzer şekilde PHT kullanıldığında MD ciddiyeti ile Vp arasında anlamlı korelasyon gözlendi (p1-2:0.002 p2-3<0.001 p1-3<0.001). Planimetrik kapak alanı referans alındığında Vp için sınır değer 48 cm/s alınması hafif MD olanları, orta ve ciddi MD olanlardan ayrımına olanak sağladı (duyarlık 77.5%, özgüllük 80%, pozitif tahmin değeri 86.1%, negatif tahmin değeri 69%). Vp için sınır değer 60 cm/s alındığında ise ciddi MD olanlar, hafif ve orta derece MD olanlardan daha iyi bir şekilde ayrılabildi (duyarlık 92.3%, özgüllük 88.5%, pozitif tahmin değeri 66.7%, negatif tahmin değeri 97.9% ).

Sonuç: : Vp, MD ciddiyetini belirlemede kullanılabilecek basit, girişimsel olmayan, güvenilir bir yöntem olabilir. Vp özellikle ciddi MD hastalarını ayırmada yüksek duyarlılık ve özgüllüğe sahiptir.z

Anahtar Kelimeler: Mitral darlığı, planimetri, PHT, M-mod akım yayılma hızı.

Kaynakça

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