Perez G L, Jacob M, Bhat P K, Rao D B, Luisada A A
J Am Geriatr Soc. 1976 Jan;24(1):29-31. doi: 10.1111/j.1532-5415.1976.tb03250.x.
One hundred patients aged 60 or older were studied clinically after excluding those with cardiac enlargement, definite valvular lesions or electrocardiographic (ECG) evidence of left ventricular hypertrophy. In 30 of the the 100 patients a significant systolic murmur was heard on auscultation. Phonocardiograms (PCGs), mitral echograms and pulse tracings were obtained in 28 of these 30 patients (2 had died meanwhile), and the ECGs and chest roentgenograms were reviewed. In 23 PCG patients there was an early or midsystolic murmur, best recorded at the base of the heart and often transmiteed to the apex. Mitral valve echograms and carotid and jugular pulse tracings were normal in all cases. Chest roentgenograms revealed aortic enlargement in 83 percent of the 23 patients. In the elderly with no evidence of organic heart disease, a basal systolic murmur is probably an aortic flow phenomenon caused by either moderate aortic dilatation or minimal fibrotic fusion of one or more commissures of the aortic valve.
对100名60岁及以上的患者进行了临床研究，排除了那些有心脏扩大、明确的瓣膜病变或心电图（ECG）显示左心室肥厚的患者。在这100名患者中，有30名在听诊时听到明显的收缩期杂音。对这30名患者中的28名（其中2名在此期间死亡）进行了心音图（PCG）、二尖瓣超声心动图和脉搏描记，并复查了心电图和胸部X线片。在23名进行心音图检查的患者中，有早期或收缩中期杂音，在心底部记录最佳，且常传至心尖。所有病例的二尖瓣超声心动图以及颈动脉和颈静脉脉搏描记均正常。胸部X线片显示，23名患者中有83%存在主动脉增宽。在无器质性心脏病证据的老年人中，心底部收缩期杂音可能是由主动脉中度扩张或主动脉瓣一个或多个瓣叶轻度纤维性融合引起的主动脉血流现象。
