Aorta, aortastenose (AS), aortaregurgitation (AR)

Aortadimensioner ved hjælp af 2D-ekkokardiografi

Normalt intervalNormalt interval, justeret
Aorta annulus20-31 mm12-14 mm/m2
Sinus valsalva29-45 mm15-20 mm/m2
Sinotubulært kryds22-36 mm13-17 mm/m2
Aorta ascendens22-36 mm13-17 mm/m2
Aortabue22-36 mm
Nedadgående aorta20-30 mm

justering refererer til justering for kropsoverfladeareal (BSA).

Standardiserede værdier for aorta (gennemsnit ± SD)

Aorta annulusSinus valsalva
AlderKvinderMændKvinderMænd
<3011.4 ± 1.111.4 ± 1.215.5 ± 1.515.3 ± 1.8
30-3911.7 ± 1.011.4 ± 1.116.5 ± 1.615.7 ± 1.3*
40-4911.7 ± 1.011.5 ± 0.916.8 ± 1.416.6 ± 1.5
50-5912.0 ± 0.911.5 ± 0.917.9 ± 1.616.8 ± 1.7*
60-6911.7 ± 1.112.1 ± 1.017.5 ± 1.717.8 ± 1.6
>7011.6 ± 1.112.0 ± 1.018.2 ± 1.918.1 ± 1.7
Alle11.7 ± 1.011.6 ± 1.017.0 ± 1.916.6 ± 1.8
Sinotubulært krydsAorta ascendens
AlderKvinderMændKvinderMænd
<3013.5 ± 1.412.7 ± 2.315.1 ± 1.614.3 ± 1.6*
30-3914.3 ± 1.513.3 ± 1.316.4 ± 1.814.5 ± 1.4*
40-4914.6 ± 1.214.1 ± 1.5*16.4 ± 1.415.5 ± 1.5*
50-5915.7 ± 1.314.1 ± 1.518.0 ± 1.416.2 ± 1.6*
60-6914.7 ± 1.615.1 ± 1.6*17.6 ± 1.717.3 ± 1.7
>7015.5 ± 2.014.7 ± 1.618.2 ± 3.317.5 ± 1.4
Alle14.7 ± 1.713.9 ± 1.816.9 ± 2.315.7 ± 1.8
Aortabue
AlderKvinderMænd
<3010.7 ± 1.010.1 ± 1.3*
30-3911.6 ± 1.610.8 ± 1.3*
40-4911.5 ± 1.211.3 ± 1.3
50-5912.7 ± 1.111.3 ± 1.2*
60-6912.5 ± 1.412.0 ± 1.1
>7012.7 ± 1.212.2 ± 1.3
Alle11.9 ± 1.511.2 ± 1.4

Aortaregurgitation (AR)

Primære parametre

Mild regurgitationModerat regurgitationAlvorlig regurgitation
Vena contracta (cm)< 0,30,3-0,6> 0,6
PHT (trykhalveringstid) – CW-doppler> 500200-500< 200
Diastolisk flow reversering – PW doppler aorta descendenshvis til stede, tidlig diastolisktidligt diastoliskholodiastolisk

Kvantificering af regurgiterende stråle

Mild regurgitationModerat regurgitationAlvorlig regurgitation
Jet-bredde / LVOT-bredde< 0,250,25-0,64> 0,64
Jet-areal / LVOT-areal< 0,050,05-0,59> 0,59

Kvalitative parametre

Mild regurgitationModerat regurgitationAlvorlig regurgitation
Jet-områdelillevarierendestor hvis central, variabel hvis excentrisk
Koaptationsdefektmildmoderatalvorlig
CW-profil aortaregurgitationsvagvariabeltæt
Størrelse venstre atriumnormalnormal eller forstørretforstørret
Størrelse venstre ventrikelnormalnormal eller forstørretforstørret

Yderligere PISA-parametre

Mild regurgitationModerat regurgitationAlvorlig regurgitation
EROA (cm²)< 0,100,10-0,29> 0,29
Regurgitationsvolumen (ml/slag)< 3030-59> 59
Regurgitationsfraktion (%)< 3030-49> 49

EROA = (CSA*v)/v (maxMR) {{ flowhastighed = CSA*v = 6,28*r2*v (aliasing)

Referencer

1. Zoghbi, William A.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Kraft, Carol D.; Levine, Robert A. et al (2003): Anbefalinger til evaluering af sværhedsgraden af nativ valvulær regurgitation med todimensionel og Doppler ekkokardiografi. I Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 16 (7), s. 777-802. DOI: 10.1016/S0894-7317 (03)00335-3.

2. Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al (2017): Anbefalinger for ikke-invasiv evaluering af nativ valvulær regurgitation. En rapport fra American Society of Echocardiography udviklet i samarbejde med Society for Cardiovascular Magnetic Resonance. I Journal of the American Society of Echocardiography : officiel publikation fra American Society of Echocardiography 30 (4), s. 303-371. DOI: 10.1016/j.echo.2017.01.007.

Aortastenose (AS)

Sygdomsdefinerende parametre

Mild stenoseModerat stenoseAlvorlig stenose
Ventilens areal (cm²)> 1,51,0-1,5< 1,0
Normaliseret ventilareal (cm²/m²)>0,850,6-0,85< 0,6

Målte parametre

Sklerose i aortaMild stenoseModerat stenoseAlvorlig stenose
Gennemsnitlig gradient (mmHg) < 2020-40> 40
Spidshastighed (m/s)1,8-2,52,6-2,93,0-4,0> 4,0
Peak gradient (mmHg) < 3535-65> 65
Hastighedsforhold (LVOT / aortaklap) > 0,50,5-0,25< 0,25

Referencer

1. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al (2009): Ekkokardiografisk vurdering af klapstenose: EAE/ASE-anbefalinger til klinisk praksis. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 (1), 1-23; quiz 101-2. DOI: 10.1016/j.echo.2008.11.029.

2. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al (2009): Ekkokardiografisk vurdering af klapstenose: EAE/ASE-anbefalinger til klinisk praksis. I European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 10 (1), s. 1-25. DOI: 10.1093/ejechocard/jen303.

3. Vahanian, Alec; Alfieri, Ottavio; Andreotti, Felicita; Antunes, Manuel J.; Barón-Esquivias, Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). I European heart journal 33 (19), s. 2451-2496. DOI: 10.1093/eurheartj/ehs109.

4. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Edvardsen, Thor; Goldstein, Steven et al. (2017): Anbefalinger om ekkokardiografisk vurdering af aortaklapstenose. En fokuseret opdatering fra European Association of Cardiovascular Imaging og American Society of Echocardiography. I Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), s. 372-392. DOI: 10.1016/j.echo.2017.02.009.

Updated on 2025-03-30