Tunaoğlu F Sedef, Olguntürk Rana, Kula Serdar, Oğuz Deniz
Department of Pediatric Cardiology, Gazi University Medical Faculty, Ankara, Turkey.
Anadolu Kardiyol Derg. 2004 Mar;4(1):3-7.
This study was designed for quantification of mitral regurgitation by echocardiographic measurements such as regurgitant volume (RV), regurgitant fraction (RF) and effective regurgitant orifice area (EROA), and to assess the effect of angiotensin converting enzyme inhibitor (ACEI) therapy on these measurements.
Patients with rheumatic mitral insufficiency were divided into two groups: Study group (SG)-10 females, 2 males, aged 10-18 years, body surface area 1.49+/-0.05 m2, receiving digoxin therapy for at least one year and Control group (CG)-8 females, 4 males, aged 8-17 years, body surface area 1.38+/-0.07 m2, with no treatment. Patients in the two groups had no symptoms of cardiac failure. Angiotensin converting enzyme inhibitor therapy was given to SG patients on admission. Echocardiographic examinations were applied on admission and at the 20th day of therapy with ACEI and digoxin.
Study group's left ventricular end-diastolic volume (108.03+/-41.21 ml/m2), mitral stroke volume (510.37+/-321.58 ml/m2) and regurgitant volume (423.48+/-305.00 ml/m2) were significantly higher (p<0.05) on admission than in the CG (81.98+/-21.53 ml/m2, 315.34+/-207.38 ml/m2 and 245.77+/-179.84 ml/m2, respectively). Aortic stroke volume at the 20th day of therapy was significantly higher in SG than in the CG. Therapy with ACEI decreased significantly SG's left ventricular end-diastolic volume.
Angiotensin converting enzyme inhibitors should be started at an early stage of mitral regurgitation. The effective regurgitant orifice area is a feasible and easy method for the outpatient follow-up of mitral regurgitation.
本研究旨在通过超声心动图测量，如反流容积（RV）、反流分数（RF）和有效反流瓣口面积（EROA）来定量二尖瓣反流，并评估血管紧张素转换酶抑制剂（ACEI）治疗对这些测量值的影响。
风湿性二尖瓣关闭不全患者分为两组：研究组（SG）——10名女性，2名男性，年龄10 - 18岁，体表面积1.49±0.05平方米，接受地高辛治疗至少一年；对照组（CG）——8名女性，4名男性，年龄8 - 17岁，体表面积1.38±0.07平方米，未接受治疗。两组患者均无心力衰竭症状。SG组患者入院时给予血管紧张素转换酶抑制剂治疗。入院时以及使用ACEI和地高辛治疗第20天时进行超声心动图检查。
研究组入院时左心室舒张末期容积（108.03±41.21 ml/m²）、二尖瓣每搏量（510.37±321.58 ml/m²）和反流容积（423.48±305.00 ml/m²）显著高于CG组（分别为81.98±21.53 ml/m²、315.34±207.38 ml/m²和245.77±179.84 ml/m²，p<0.05）。治疗第20天时，SG组的主动脉每搏量显著高于CG组。ACEI治疗显著降低了SG组的左心室舒张末期容积。
二尖瓣反流应早期开始使用血管紧张素转换酶抑制剂。有效反流瓣口面积是二尖瓣反流门诊随访的一种可行且简便的方法。
