Kalmanson D, Veyrat C, Bernier A, Witchitz S, Chiche P
Br Heart J. 1976 Feb;38(2):135-46. doi: 10.1136/hrt.38.2.135.
In 15 patients with pure or predominant mitral stenosis and in a control group of 11 patients without mitral stenosis the blood flow velocity through the mitral valve orifice was recorded by means of a directional Doppler ultrasound velocity catheter introduced transeptally and positioned in the orifice of the mitral valve. A simultaneous surface phonocardiogram was obtained. The timing of the mitral opening snap in relation to the blood velocity record of the flow through the valve supported the hypothesis that the opening snap is due to a sudden tensing of the valve leaflets by the chordae tendineae. Determination of the exact time of mitral valve opening, made possible by the blood velocity record, led to the division of the classical A2-0S interval (aortic valve closure to opening snap) into two components representing respectively the diastolic isovolumic relaxation period and the time of excursion of the mitral valve cusps. The durations of the isovolumic relaxation period were compared with those in the control patients and were found to correlate with the severity of the mitral stenosis, whereas those of the excursion time of the mitral cusps were influenced by the presence or absence of mitral valve calcification.
对15例单纯或主要为二尖瓣狭窄的患者以及11例无二尖瓣狭窄的对照组患者，经房间隔插入定向多普勒超声速度导管并置于二尖瓣口，记录通过二尖瓣口的血流速度。同时记录体表心音图。二尖瓣开瓣音相对于瓣膜血流速度记录的时间支持了这样的假说，即开瓣音是由于腱索突然拉紧瓣膜小叶所致。血流速度记录使得确定二尖瓣开放的确切时间成为可能，从而将经典的A2-OS间期（主动脉瓣关闭至开瓣音）分为两个部分，分别代表舒张期等容舒张期和二尖瓣叶的移动时间。将等容舒张期的持续时间与对照组患者的进行比较，发现其与二尖瓣狭窄的严重程度相关，而二尖瓣叶移动时间的持续时间则受二尖瓣钙化存在与否的影响。
