超声心动图评价二叶化主动脉瓣分型及其特征

Echocardiography evaluation of morphology and characteristics of bicuspid aortic valve

  • 摘要: 目的 探讨不同分型的二叶化主动脉瓣畸形患者的临床及超声心动图特征。 方法 回顾分析2008年11月- 2014年6月于解放军总医院诊断为二叶化主动脉瓣畸形的住院患者的临床及超声心动图特点。 结果 81例二叶化主动脉畸形患者中,Ⅰ型(前后型)29例,Ⅱ型(左右型)52例。两型组基线资料及左心室功能差异均无统计学意义。Ⅰ型组主动脉瓣中-重度反流、主动脉窦部增宽的发生率均较Ⅱ型组高(P< 0.05),Ⅱ型组主动脉瓣中-重度狭窄的发生率较Ⅰ型组高(P< 0.05),两组升主动脉扩张的发生率差异无统计学意义(P=0.300)。Ⅰ型组主动脉瓣环径、窦内径及窦管结合径均较Ⅱ型组宽(P< 0.05)。两组升主动脉内径差异无统计学意义(P=0.146)。 结论 二叶化主动脉瓣畸形以左右型多见,前后型好发主动脉瓣中-重度反流,左右型好发主动脉瓣中-重度狭窄,前后型的瓣环径、窦内径及窦管结合径均大于左右型。

     

    Abstract: Objective To explore the differences between two types of bicuspid aortic valve (BAV) patients in clinical and echocardiographic features. Methods Clinical and echocardiographic data about BAV patients who admitted to our hospital from November 2008 to June 2014 were retrospectively analyzed. Results Of the 81 BAV patients, 29 patients were Type Ⅰ(A-P type)BAV and 52 patients were Type Ⅱ(L-R type) BAV. Baseline demographics and left heart function were similar between two groups. Type Ⅰ group had higher incidence of moderate-severe aortic regurgitation (AR) and enlarged aortic sinus than that of Type Ⅱ group(P< 0.05). Type Ⅱ group had higher incidence of moderate-severe aortic stenosis (AS) than that of Type I group (P< 0.05). The incidence of enlarged ascending aorta were similar between two groups (P=0.300). Type I group had larger aortic annulus, sinus and sinotubular junction dimensions compared to Type Ⅱ group (P< 0.05). There was no significant difference in ascending aorta dimensions between two groups (P=0.146). Conclusion BAV is dominant in L-R type. A-P type is dominant in moderate-severe AR,L-R type is dominant in moderate-severe AS. A-P type patients have larger aortic annulus, sinus and sinotubular junction dimensions than that of L-R type patients.

     

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