Debeljacki D, Benc D, Panić G, Jung R
Institut za kardiovaskularne bolesti, Sremska Kamenica, Medicinski fakultet, Novi Sad.
Med Pregl. 2000 May-Jun;53(5-6):277-84.
The study included 128 patients treated at the Institute of Cardiovascular Diseases in Sremska Kamenica within a year after the first posteroinferior myocardial infarction. On the basis of hemodynamic measurements, patients were divided into 2 groups. Group I (examinees) included 64 patients (58 males and 6 females, mean age 54.42 +/- 6.70 years) with proven mitral regurgitation and group 2 (control) included 64 patients (56 males and 8 females, mean age 51.71 +/- 8.84 years) without mitral regurgitation, but with stenotic changes in the right coronary artery and left circumflex coronary artery without significant stenotic lesions at the anterior descending left coronary artery. According to Sellers classification mitral regurgitation in group I was as follows: I grade 37.5%, II grade 31.3%, III grade 21.9% and IV grade 9.3%. Measured hemodynamic parameters in basal conditions (systolic, diastolic and mean pulmonary pressure, capillary pulmonary pressure and wave V, left ventricular end-diastolic pressure) point to significant impairment of diastolic function in group I apart from similar values of systolic function (cardiac output, cardiac index and ejection fraction). Dimension of the left atrium and left ventricle determined by transthoracic echocardiography confirm this. There was a positive correlation of examined parameters (pulmonary capillary and total pulmonary resistance) and the degree of mitral regurgitation, as well as the correlation between the degree of mitral regurgitation and hemodynamic parameters. It may be concluded that postinfarction mitral regurgitation in examined patients is of II degree on the average; total and capillary pulmonary resistance are most sensitive hemodynamic parameters for examining the severity of mitral regurgitation, whereas the size of the left atrium is the most sensitive echocardiographic parameter.
该研究纳入了128例在斯雷姆斯卡-卡梅尼察心血管疾病研究所接受治疗的患者，这些患者均在首次后下壁心肌梗死后一年内。根据血流动力学测量结果，将患者分为两组。第一组（受检者）包括64例患者（58例男性和6例女性，平均年龄54.42±6.70岁），经证实存在二尖瓣反流；第二组（对照组）包括64例患者（56例男性和8例女性，平均年龄51.71±8.84岁），无二尖瓣反流，但右冠状动脉和左旋支冠状动脉有狭窄改变，左前降支冠状动脉无明显狭窄病变。根据塞勒斯分类法，第一组的二尖瓣反流情况如下：I级占37.5%，II级占31.3%，III级占21.9%，IV级占9.3%。在基础状态下测量的血流动力学参数（收缩压、舒张压和平均肺动脉压、肺毛细血管压和V波、左心室舒张末期压力）表明，除收缩功能（心输出量、心脏指数和射血分数）值相似外，第一组的舒张功能有明显受损。经胸超声心动图测定的左心房和左心室大小证实了这一点。所检查的参数（肺毛细血管阻力和总肺阻力）与二尖瓣反流程度呈正相关，二尖瓣反流程度与血流动力学参数之间也存在相关性。可以得出结论，受检患者的梗死后二尖瓣反流平均为II度；总肺阻力和肺毛细血管阻力是检查二尖瓣反流严重程度最敏感的血流动力学参数，而左心房大小是最敏感的超声心动图参数。
