Pezzano A, Brusoni B, Bossi M, Bianchi E M, Casolo F, Rovelli F
G Ital Cardiol. 1976;6(7):1259-75.
100 patients with mitral prolapse syndrome (MPS) were studied with electrocardiogram, phonocardiogram, thorax radiography and echocardiogram. In 44 of the patients, the effort test and dynamic electrocardiogram were performed; 25 underwent hemodynamic examination, and 10 underwent selective coronarography. The most frequent symptomatologies were palpitations and vertigo; the most-registered electrocardiographic alterations were ventricular extrasystoles and altered electrical repolarization in the inferior seat. The symptomatic patients with rhythm disturbances showed reduced work capacity (RWC) with aggravation of the effort arrhythmias. The phonocardiogram showed variability of the phonoauscultatory reports, not only from patient to patient, but also in the same patient. The apicocardiogram presented a characteristic systolic re-entry which coincided with the non-ejective click. In all cases, the echocardiogram demonstrated a systolic movement backwards from the mitralic strips with different aspects. The endocavitary pressures in the studied cases were normal or only slightly altered. The left ventriculography frequently demonstrated assynergic areas, and constantly, eversion of the posterior mitralic strips in the left atrium. In most of the cases, the selective coronarography showed the absence of the ventricular atrial tract of the circumflex. The sustained role of the mixomatous degeneration in the pathogenetic mechanism of the MPS must be emphasized. The beta-blockers were the most effective drugs against arrhythmias, which in some cases showed themselves impervious to any medicinal treatment. MPS is considered a very diffuse disease which can run its course without detection or which can be accompanied by serious rhythm disturbances that can threaten the patient's life. The importance of echocardiography in the diagnosis of MPS is emphasized. The SPM patient showed undergo a series of wave tests which reveal malignant potentialities, so that the best therapeutic principles, both for the treatment and prevention of the arrhythmias, can be applied.
对100例二尖瓣脱垂综合征（MPS）患者进行了心电图、心音图、胸部X线摄影和超声心动图检查。其中44例患者进行了运动试验和动态心电图检查；25例接受了血流动力学检查，10例接受了选择性冠状动脉造影。最常见的症状是心悸和眩晕；最常见的心电图改变是室性期前收缩和下壁导联电复极异常。有症状的心律失常患者运动耐力降低（RWC），运动性心律失常加重。心音图显示心音听诊报告存在差异，不仅患者之间不同，同一患者也存在差异。心尖心动图呈现特征性的收缩期折返，与非喷射性喀喇音一致。在所有病例中，超声心动图均显示二尖瓣叶有不同形式的收缩期向后运动。研究病例的心腔内压力正常或仅略有改变。左心室造影经常显示不协调区域，且总是显示二尖瓣后叶在左心房内翻转。在大多数病例中，选择性冠状动脉造影显示回旋支不存在室房通道。必须强调黏液样变性在MPS发病机制中的持续作用。β受体阻滞剂是抗心律失常最有效的药物，在某些情况下，心律失常对任何药物治疗都无反应。MPS被认为是一种非常普遍的疾病，可能在未被发现的情况下发展，或者可能伴有严重的心律失常，威胁患者生命。强调了超声心动图在MPS诊断中的重要性。患有二尖瓣脱垂综合征的患者需进行一系列波动测试，以揭示恶性潜能，从而能够应用最佳的治疗原则来治疗和预防心律失常。
