Kai H, Koyanagi S, Takeshita A
Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am Heart J. 1992 Nov;124(5):1297-304. doi: 10.1016/0002-8703(92)90415-r.
The incidence of and the Doppler color-flow echocardiographic characteristics of aortic valve prolapse with nonrheumatic aortic regurgitation were examined. Aortic valve prolapse was observed in 21 of 243 patients (15 men and 6 women) with aortic regurgitation as detected by Doppler color-flow echocardiography (rheumatic, 112; nonrheumatic, 131) in 1247 consecutive patients. Patients with aortic valve prolapse included three patients with essential hypertension and one with annuloaortic ectasia. The remaining 17 patients (7% of those with aortic regurgitation) had no other associated cardiovascular disease (idiopathic aortic valve prolapse). Prolapse of the mitral or the tricuspid valve or both was associated with aortic valve prolapse in seven patients. Aortic regurgitation jet was markedly deviated from the axis of left ventricular outflow tract toward the anterior mitral leaflet or the interventricular septum in 17 of 21 (81%) patients with aortic valve prolapse, whereas 28 of 110 (25%) patients with nonrheumatic aortic regurgitation without prolapse and 17 of 112 (15%) patients with rheumatic aortic regurgitation without prolapse showed the deviation of regurgitant jet (p < 0.001). In conclusion, idiopathic aortic valve prolapse is one of the significant causes of aortic regurgitation, and a marked deviation of regurgitant jet is a characteristic Doppler color-flow echocardiographic finding of aortic regurgitation that results from aortic valve prolapse.
我们对非风湿性主动脉瓣反流合并主动脉瓣脱垂的发病率及多普勒彩色血流超声心动图特征进行了研究。在连续1247例患者中，通过多普勒彩色血流超声心动图检测到243例主动脉瓣反流患者（风湿性112例，非风湿性131例），其中21例（15例男性，6例女性）存在主动脉瓣脱垂。主动脉瓣脱垂患者中包括3例原发性高血压患者和1例主动脉瓣环扩张患者。其余17例患者（占主动脉瓣反流患者的7%）无其他相关心血管疾病（特发性主动脉瓣脱垂）。7例患者的二尖瓣或三尖瓣或两者脱垂与主动脉瓣脱垂相关。在21例主动脉瓣脱垂患者中，17例（81%）的主动脉反流束明显偏离左心室流出道轴线，朝向二尖瓣前叶或室间隔，而在110例无脱垂的非风湿性主动脉瓣反流患者中，28例（25%）以及112例无脱垂的风湿性主动脉瓣反流患者中，17例（15%）出现反流束偏离（p<0.001）。总之，特发性主动脉瓣脱垂是主动脉瓣反流的重要原因之一，反流束明显偏离是主动脉瓣脱垂所致主动脉瓣反流的特征性多普勒彩色血流超声心动图表现。
