Медицинская литература. Новинки

 

 

 

 

 

 

К вопросу об эхокардиографической оценке следовой (тривиальной) аортальной регургитации

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Аортальная регургитация, как правило, ассоциируется с недостаточностью полулунных заслонок аорты, которая рассматривается как клапанный порок сердца. В отличие от других клапанов сердца, в литературе до сих пор нет единого мнения о возможности наличия физиологической регургитации на аортальном клапане. К сожалению, также отсутствуют общепринятые эхокардиографические критерии следовой (тривиальной) аортальной регургитации. В статье представлены данные анализа литературы о распространенности, терминологии и критериях оценки следовой (тривиальной) аортальной регургитации у здоровых лиц по данным эхокардиографии. Рассматриваются возможные сложности и ошибки при эхокардиографической оценке очень маленькой аортальной регургитации.

Ключевые слова:
эхокардиография, допплерэхокардиография, аортальный клапан, аортальная регургитация, следовая (тривиальная) аортальная регургитация, диаметр выносящего тракта левого желудочка, echocardiography, Doppler echocardiography, aortic valve, aortic regurgitation, trace (trivial) aortic regurgitation, left ventricular outflow tract diameter

Литература:
1.Iung B., Baron G., Butchart E.G., Delahaye F., Gohlke-Barwolf C., Levang O.W., Tornos P., Vanoverschelde J.L., Vermeer F., Boersma E., Ravaud P., Vahanian A. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on valvular heart disease // Eur. Heart J. 2003. V. 24. No. 13. P. 1231-1243.
2.Singh J.P., Evans J.C., Levy D., Larson M.G., Freed L.A., Fuller D.L., Lehman B., Benjamin E.J. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) // Am. J. Cardiol. 1999. V. 83. No. 6. P. 897-902.
3.Akasaka T., Yoshikawa J., Yoshida K., Okum achi F., Koizumi K., Shiratori K., Takao S., Shakudo M., Kato H. Age-related valvular regurgitation: a study by pulsed Doppler echocardiography // Circulation. 1987. V. 76. No. 2. P. 262-265.
4.Armstrong W.F., Ryan T. Feigenbaum’s Echocardiography. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2010. 816 p.
5.Okura H., Takada Y., Yamabe A., Ozaki T., Yamagishi H., Toda I., Yoshiyama M., Yoshikawa J., Yoshida K. Prevalence and correlates of physiological valvular regurgitation in healthy subjects // Circ. J. 2011. V. 75. No. 11. P. 2699-2704.
6.Rezzoug N., Vaes B., de Meester C., Degryse J., Van Pottelbergh G., Mathei C., Adriaensen W., Pasquet A., Vanoverschelde J.L. The clinical impact of valvular heart disease in a populationbased cohort of subjects aged 80 and older // BMC Cardiovasc. Disord. 2016. V. 16. No. 7. Doi: 10.1186/s12872-016-0184-8.
7.Lee S.T., Lin M.H. Color Doppler echocardiographic assessment of valvular regurgitation in normal infants // J. Formos. Med. Assoc. 2010. V. 109. No. 1. P. 56-61.
8.Ayabakan C., Ozkutlu S., Kilic A. The Doppler echocardiographic assessment of valvular regurgitation in normal children // Turk. J. Pediatr. 2003. V. 45. No. 2. P. 102-107.
9.Reid C.L., Anton-Culver H., Yunis C., Gardin J.M. Prevalence and clinical correlates of isolated mitral, isolated aortic regurgitation, and both in adults aged 21 to 35 years (from the CARDIA study) // Am. J. Cardiol. 2007. V. 99. No. 6. P. 830-834.
10.Strader J.R., Harrell T.W., Adair A., Kruyer W.B. Efficacy of echocardiographic screening of pilot applicants // Aviat. Space Environ. Med. 2008. V. 79. No. 5. P. 514-517.
11.Berger M., Hecht S.R., Van Tosh A., Lingam U. Pulsed and continuous wave Doppler echocardiographic assessment of valvular regurgitation in normal subjects // J. Am. Coll. Cardiol. 1989. V. 13. No. 7. P. 1540-1545.
12.Yoshida K., Yoshikawa J., Shakudo M., Akasaka T., Jyo Y., Takao S., Shiratori K., Koizumi K., Okumachi F., Kato H., Fukaya T. Color Doppler evaluation of valvular regurgitation in normal subjects // Circulation. 1988. V. 78. No. 4. P. 840-847.
13.Brand A., Dollberg S., Keren A. The prevalence of valvular regurgitation in children with structurally normal hearts: a color Doppler echocardiographic study // Am. Heart J. 1992. V. 123. No. 1. P. 177-180.
14.Zoghbi W.A., Adams D., Bonow R.O., Enriquez-Sarano M., Foster E., Grayburn P.A., Hahn R.T., Han Y., Hung J., Lang R.M., Little S.H., Shah D.J., Shernan S., Thavendiranathan P., Thomas J.D., Weissman N.J. Recommendations for noninvasive evaluation of native valvular regurgitation. A report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance // J. Am. Soc. Echocardiogr. 2017. V. 30. No. 4. P. 303-371. Doi: 10.1016/j.echo.2017.01.007.
15.Шиллер Н., Осипов М.А. Клиническая эхокардиография. Изд. 2-е. М.: Практика, 2005. 344 с.
16.Райдинг Э. Эхокардиография. Практическое руководство. (Перевод с английского). М.: Медпресс-Информ, 2010. 280 с.
17.Рыбакова М.К., Алехин М.Н., Митьков В.В. Практическое руководство по ультразвуковой диагностике. Эхокардиография. М.: Видар, 2008. 512 с.
18.Otto C.M. Textbook of Clinical Echocardiography. 5th ed. Philadelphia: Saunders, 2013. 576 p.
19.Webb R.H., Gentles T.L., Stirling J.W., Lee M., O’Donnell C., Wilson N.J. Valvular regurgitation using portable echocardiography in a healthy student population: implications for rheumatic heart disease screening // J. Am. Soc. Echocardiogr. 2015. V. 28. No. 8. P. 981-988. Doi: 10.1016/j.echo.2015.03.012.
20.Jobic Y., Slama M., Tribouilloy C., Lan Cheong Wah L., Choquet D., Boschat J., Penther P., Lesbre J.P. Doppler echocardiographic evaluation of valve regurgitation in healthy volunteers // Br. Heart J. 1993. V. 69. No. 2. P. 109-113.
21.Sahn D.J., Maciel B.C. Physiological valvular regurgitation. Doppler echocardiography and the potential for iatrogenic heart disease // Circulation. 1988. V. 78. No. 4. P. 1075-1077.
22.Houston A.B. Doppler ultrasound and the apparently normal heart // Br. Heart J. 1993. V. 69. No. 2. P. 99-100.
23.Gardin J.M., Adams D.B., Douglas P.S., Feigenbaum H., Forst D.H., Fraser A.G., Grayburn P.A., Katz A.S., Keller A.M., Kerber R.E., Khandheria B.K., Klein A.L., Lang R.M., Pierard L.A., Quinones M.A., Schnittger I., American Society of Echocardiography. Recommendations for a standardized report for adult transthoracic echocardiography: a report from the American Society of Echocardiography’s Nomenclature and Standards Committee and Task Force for a Standardized Echocardiography Report // J. Am. Soc. Echocardiogr. 2002. V. 15. No. 3. P. 275-290.
24.Remenyi B., Wilson N., Steer A., Ferreira B., Kado J., Kumar K., Lawrenson J., Maguire G., Marijon E., Mirabel M., Mocumbi A.O., Mota C., Paar J., Saxena A., Scheel J., Stirling J., Viali S., Balekundri V.I., Wheaton G., Zuhlke L., Carapetis J. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease - an evidence-based guideline // Nat. Rev. Cardiol. 2012. V. 9. No. 5. P. 297-309. Doi: 10.1038/nrcardio.2012.7.
25.Nishimura R.A., Otto C.M., Bonow R.O., Carabello B.A., Erwin J.P. 3rd, Guyton R.A., O’Gara P.T., Ruiz C.E., Skubas N.J., Sorajja P., Sundt T.M. 3rd, Thomas J.D.; ACC/AHA Task Force Members. 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines // Circulation. 2014. V. 129. No. 23. P. 2440-2492. Doi: 10.1161/CIR.0000000000000029.
26.Kerut E.K., McIlwain E.F., Plotnick G.D. Handbook of Echo-Doppler Interpretation. 2nd ed. Elmsford, New York: Wiley-Blackwell, 2004. 410 p.
27.Strader J.R., Gray G.W., Kruyer W.B. Clinical aerospace cardiovascular medicine // Fundamentals of Aerospace Medicine. 4th ed. / Ed. by J.R. Davis, R. Johnson, J. Stepanek, J.A. Fogarty. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2008. P. 318-348.
28.Perry G.J., Helmcke F., Nanda N.C., Byard C., Soto B. Evaluation of aortic insufficiency by Doppler color flow mapping // Am. Coll. Cardiol. 1987. V. 9. No. 4. P. 952-959.
29.Solomon S.D., Bulwer B. Essential Echo cardiography: a Practical Handbook with DVD. Totowa, New Jersey: Humana Press, 2007. 458 p.
30.Otto C.M. The Practice of Clinical Echocardiography. 3rd ed. Philadelphia: W.B. Saunders, 2007. 1153 p.
31.Leye M., Brochet E., Lepage L., Cueff C., Boutron I., Detaint D., Hyafil F., Iung B., Vahanian A., Messika-Zeitoun D. Size-adjusted left ventricular outflow tract diameter reference values: a safeguard for the evaluation of the severity of aortic stenosis // J. Am. Soc. Echocardiogr. 2009. V. 22. No. 5. P. 445-451. Doi: 10.1016/j.echo.2009.02.007.
32.Shiran A., Adawi S., Ganaeem M., Asmer E. Accuracy and reproducibility of left ventricular outflow tract diameter measurement using transthoracic when compared with transesophageal echocardiography in systole and diastole // Eur. J. Echocardiogr. 2009. V. 10. No. 2. P. 319-324. Doi: 10.1093/ejechocard/jen254.
33.Reynolds T., Abate J., Tenney A., Warner M.G. The JH/LVOH method in the quantification of aortic regurgitation: how the cardiac sonographer may avoid an important potential pitfall // J. Am. Soc. Echocardiogr. 1991. V. 4. No. 2. P. 105-108.

Echocardiographic assessment of trace (trivial) aortic regurgitation

Aortic regurgitation usually is associated with insufficiency of aorta semilunar valves, which is considered as valvular heart disease. Unlike other heart valves, there is still no consensus about the possible presence of physiological regurgitation in the aortic valve in the literature. Unfortunately there are no generally accepted echocardiographic criteria for the trace (trivial) aortic regurgitation. The article presents a critical literature review of the prevalence, terminology, and evaluation criteria for trace (trivial) aortic regurgitation in healthy individuals. Possible pitfalls and mistakes in echocardiographic assessment of trace (trivial) aortic regurgitation are discussed.

Keywords:
эхокардиография, допплерэхокардиография, аортальный клапан, аортальная регургитация, следовая (тривиальная) аортальная регургитация, диаметр выносящего тракта левого желудочка, echocardiography, Doppler echocardiography, aortic valve, aortic regurgitation, trace (trivial) aortic regurgitation, left ventricular outflow tract diameter