OBJECTIVE: We sought to assess the correlation between sonographic pulmonary congestion, invasive LV pre-A pressure, and echocardiographic LV end-diastolic pressure (LVEDP) in symptomatic AS patients receiving transcatheter aortic valve replacement.
METHODS: Forty-eight consecutive patients with severe AS and planned transcatheter aortic valve implantation (TAVI) were enrolled. LVEDP was estimated to be normal or elevated using the ASE/EACVI algorithm and transmitral Doppler indices, the E/A ratio, the E/e\', and the left atrial volume index. Invasive LV pre-A pressure was used as a reference, with > 12 mm Hg defined as elevated.
RESULTS: Forty-eight patients (25 women (52%), mean age 75 years, standard deviation (SD) ± 7.7 years) were enrolled in the study. We detected severe B-lines (≥ 30) in 13 (27%) patients and moderate B-lines (15-30) in 33 (68.6%) patients. The number of B-lines increased significantly with the severity of New York Heart Association (NYHA) functional classes (Fig. 1). The B-line count was 14 ± 13 in NYHA class I patients, 20 ± 20 in class II patients, and 44 ± 35 in class III patients (p < 0.05, rho = 0.384). The number of B-lines was correlated with the E/E\' ratio (R = 0.664, p < 0.0001) and the proBNP level (R = 0. 882, p < 0.008). We found no significant correlation with the LVEDP or LVEF. The LVEDP correlated well with the E/E\' ratio (R = 0.491, p < 0.001) but not at all with E/A, DT, or LAVI. All patients had an elevated LVEDP > 12, with a mean pressure of 26 mmHg, a minimum of 13 mmHg, and a maximum of 45 mmHg, with an SD of 7.85.
CONCLUSIONS: Assessing lung ultrasonic B-lines is a straightforward and practical approach to identifying pulmonary oedema in AS patients. The number of B-lines correlated with the E/E\' ratio and the functional status of patients but did not correlate with invasive LVEDP or LVEF. All patients had elevated LVEDP that correlated with E/E\'.
目的:我们试图评估超声检查肺充血,有创左心室A前压力,接受经导管主动脉瓣置换术的有症状AS患者的超声心动图LV舒张末期压(LVEDP)。
方法:纳入48例连续的重度AS和计划的经导管主动脉瓣植入术(TAVI)患者。使用ASE/EACVI算法和透射多普勒指数估计LVEDP正常或升高。E/A比,E/E\',和左心房容积指数。使用有创左心室A前压力作为参考,>12mmHg定义为升高。
结果:48名患者(25名女性(52%),平均年龄75岁,标准差(SD)±7.7年)纳入研究.我们在13例(27%)患者中检测到重度B线(≥30),在33例(68.6%)患者中检测到中度B线(15-30)。随着纽约心脏协会(NYHA)功能等级的严重程度,B线的数量显着增加(图。1).NYHAI级患者的B线计数为14±13,II类患者20±20,III类患者为44±35(p<0.05,rho=0.384)。B线的数量与E/E比值(R=0.664,p<0.0001)和proBNP水平(R=0)相关。882,p<0.008)。我们发现与LVEDP或LVEF没有显着相关性。LVEDP与E/E比值(R=0.491,p<0.001)相关良好,但与E/A完全无关,DT,或者LAVI.所有患者的LVEDP升高>12,平均压力为26mmHg,最低13mmHg,最高45mmHg,SD为7.85。
结论:评估肺部超声B线是确定AS患者肺水肿的一种简单而实用的方法。B线的数量与E/E比值和患者的功能状态相关,但与侵入性LVEDP或LVEF无关。所有患者的LVEDP升高与E/E'相关。