Imai T, Ohkawa S, Watanabe C, Chida K, Maeda S, Kuboki K, Sugiura M
Division of Cardiology, Tokyo Metropolitan Geriatric Hospital.
J Cardiol Suppl. 1992;28:55-62; discussion 63-5.
Similar morphologic abnormalities have often been observed in the leaflets of tricuspid valve in patients with mitral valve prolapse. In the present study, morphologic tricuspid valve prolapse was analyzed in 500 consecutive autopsies of the aged over 60 years (mean 78.5 yrs, 266 men, 234 women). Additionally, the sensitivity and specificity of the color Doppler technique applied before death were assessed in 61 autopsy cases. The results were as follows: 1. The incidence of morphologic tricuspid valve prolapse was 22.2% at autopsy in 500 cases of the aged, however, tricuspid regurgitation had not clinically been detected in any of them. 2. The prolapse of 2- or 3-leaflets was common (78.5%). Among the 3 leaflets, the prolapse was more frequently observed in the anterior or posterior leaflet than in the septal leaflet. Combined tricuspid and mitral valve prolapses were observed in 22 cases (19.8%). 3. Among 61 cases examined by color Doppler echocardiography, autopsy showed that 16 cases had tricuspid valve prolapse and 14 cases tricuspid regurgitant flow signals (87.5%). 4. Regurgitant flow signals were also detected in 4 of 12 morphologically normal cases (33.3%). 5. In autopsy cases of the aged, generally, the incidence of morphologic tricuspid valve prolapse and tricuspid regurgitant flow signal were high, however, hemodynamically significant regurgitation due to prolapse was very rare.
在二尖瓣脱垂患者中,常常可观察到三尖瓣小叶出现类似的形态学异常。在本研究中,对500例连续的60岁以上老年人(平均78.5岁,男性266例,女性234例)尸体解剖进行了形态学三尖瓣脱垂分析。此外,还对61例尸检病例生前应用彩色多普勒技术的敏感性和特异性进行了评估。结果如下:1. 在500例老年人尸检中,形态学三尖瓣脱垂的发生率为22.2%,然而,临床上未在其中任何一例中检测到三尖瓣反流。2. 两叶或三叶脱垂较为常见(78.5%)。在三叶中,前叶或后叶的脱垂比隔叶更常见。观察到22例(19.8%)合并三尖瓣和二尖瓣脱垂。3. 在61例经彩色多普勒超声心动图检查的病例中,尸检显示16例有三尖瓣脱垂,14例有三尖瓣反流信号(87.�%)。4. 在12例形态学正常的病例中,有4例(33.3%)也检测到反流信号。5. 在老年人尸检病例中,一般来说,形态学三尖瓣脱垂和三尖瓣反流信号的发生率较高,然而,因脱垂导致的血流动力学显著反流非常罕见。