RESULTS: We studied 111 patients with rheumatic MS who underwent both transthoracic echocardiography (TTE) and a TEE assessment of MS severity. Yeo\'s index, the MVA determined by 2D planimetry, pressure half-time (PHT) and continuity equation (CE) measured on TTE were compared with the TEE 3DMVA. With a linear correlation, Yeo\'s index showed the best correlation with TEE 3DMVA (r2 = 0.775), followed by 2D planimetry (r2 = 0.687), CE (r2 = 0.598) and PHT (r2 = 0.363). Using TEE 3DMVA as comparator, Yeo\'s index (ρc = 0.739) demonstrated the best concordance, followed by 2D planimetry (ρc = 0.632), CE (ρc = 0.464) and PHT (ρc = 0.366). When both Yeo\'s index and 2D planimetry suggested significant MS, the positive predictive value was high (an AUC of 0.966 and a PPV of 100.00% for severe MS, and an AUC of 0.864 and a PPV of 85.71% for very severe MS). When both measures suggested the absence of significant MS, the negative predictive value was also high (an AUC of 0.940 and an NPV of 88.90% for severe MS, and an AUC of 0.831 and an NPV of 88.71% for very severe MS).
CONCLUSIONS: Yeo\'s index performed well in identifying severe MS when compared with TEE 3DMVA and may be a useful adjunct to existing methods of measuring MS severity. Combining it with 2D planimetry could further enhance its accuracy.
结果:我们研究了111例风湿性MS患者,他们接受了经胸超声心动图(TTE)和TEE对MS严重程度的评估。Yeo\的索引,通过二维平面法确定的MVA,在TTE上测量的压力半衰期(PHT)和连续性方程(CE)与TEE3DMVA进行了比较。具有线性相关关系,Yeo指数与TEE3DMVA的相关性最好(r2=0.775),其次是二维平面测量(r2=0.687),CE(r2=0.598)和PHT(r2=0.363)。使用TEE3DMVA作为比较器,Yeo指数(ρc=0.739)表现出最佳一致性,其次是二维平面测量(ρc=0.632),CE(ρc=0.464)和PHT(ρc=0.366)。当Yeo指数和2D平面测量都显示出显著的MS时,阳性预测值高(重度MS的AUC为0.966,PPV为100.00%,对于非常严重的MS,AUC为0.864,PPV为85.71%)。当两种测量都表明没有明显的MS时,阴性预测值也很高(重度MS的AUC为0.940,NPV为88.90%,对于非常严重的MS,AUC为0.831,NPV为88.71%)。
结论:与TEE3DMVA相比,Yeo指数在识别重度MS方面表现良好,可能是现有MS严重程度测量方法的有用辅助手段。将其与2D平面测量相结合可以进一步提高其准确性。