Inada Keiichi, Komukai Kimiaki, Mori Chikara, Nagasawa Hidetaka, Shibata Takahiro, Mochizuki Seibu
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo.
Intern Med. 2004 Jan;43(1):55-8. doi: 10.2169/internalmedicine.43.55.
Hypertrophic obstructive cardiomyopathy (HOCM), which shows left ventricular outflow pressure gradient (LVPG), is often complicated with mitral regurgitation (MR). We examined a 62-year-old Japanese female with HOCM and MR. Ultrasound echocardiography showed severe MR, asymmetrical septal hypertrophy, systolic anterior movement of the mitral valve anterior leaflet, and left ventricular outflow stenosis. Her LVPG, measured using continuous wave Doppler recording, was 118 mmHg. During heart catheterization, the aortic pressure and left ventricular pressure were simultaneously measured. An intravenous injection of 70 mg cibenzoline decreased the LVPG from 110 mmHg to 16 mmHg. Left ventriculography was performed immediately after the injection and did not show MR. This clearly demonstrates that cibenzoline decreases LVPG in patients with HOCM and also improves the MR that arises from LVPG.
肥厚型梗阻性心肌病（HOCM）表现为左心室流出道压力阶差（LVPG），常合并二尖瓣反流（MR）。我们检查了一名62岁患有HOCM和MR的日本女性。超声心动图显示严重的MR、不对称性室间隔肥厚、二尖瓣前叶收缩期前向运动以及左心室流出道狭窄。使用连续波多普勒记录测得她的LVPG为118 mmHg。在心脏导管检查期间，同时测量了主动脉压力和左心室压力。静脉注射70 mg西苯唑啉后，LVPG从110 mmHg降至16 mmHg。注射后立即进行左心室造影，未显示MR。这清楚地表明西苯唑啉可降低HOCM患者的LVPG，并改善由LVPG引起的MR。
