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Abstract：
BACKGROUND: Yeo\'s index is a novel measure of the severity of rheumatic mitral valve stenosis (MS). It is derived from the product of the mitral leaflet separation index and dimensionless index. This study aims to validate Yeo\'s index using a transesophageal echocardiogram (TEE) three-dimensional (3D) mitral valve area (MVA) as a comparator and to compare the concordance of existing echocardiographic measures of the MVA with TEE 3DMVA.
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.
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.
摘要：
背景：Yeo指数是风湿性二尖瓣狭窄（MS）严重程度的新指标。它来自二尖瓣小叶分离指数和无量纲指数的乘积。本研究旨在使用经食管超声心动图（TEE）三维（3D）二尖瓣面积（MVA）作为比较器验证Yeo指数，并比较现有的MVA超声心动图测量值与TEE3DMVA的一致性。
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。
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。
