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[二尖瓣脱垂综合征患者的心律失常与交感神经系统状态]

[Arrhythmia in patients with mitral valve prolapse syndrome and the status of the sympathetic nervous system].

作者信息

Sniezek-Maciejewska M, Piwowarska W, Mroczek-Czernecka D, Mazurek S, Kmita A, Jaśkiewicz J, Dubiel J P

机构信息

I Kliniki Kardiologii, Instytutu Pediatrii AM w Krakowie.

出版信息

Pol Tyg Lek. 1990;45(10-11):203-5.

PMID:1699213
Abstract

The study aimed at evaluating a possible relationship between the adrenergic system tone determined with the excretion of catecholamines with the urine and an incidence of the ventricular arrhythmias in patients with the mitral valve prolapse. The study included 20 patients (13 women and 7 men aged between 20 and 50 years; mean = 31.6 years) with the mitral valve prolapse syndrome diagnosed with the aid of the patients' history, physical examinations and echocardiography. Echocardiograms have shown anterior mitral leaflet prolapse in 7 patients, posterior mitral leaflet prolapse in 8 patients, and both mitral leaflets prolapse in the remaining 5 patients. Daily excretion of adrenaline and noradrenaline was measured with Van Euler and Lishajko's fluorimetric technique. Cardiac arrhythmias were determined with a 24-hour ECG monitoring and classified according to Lown. Premature ventricular contractions of class I were seen in 1 patient, of class II in 5, class III in 1, class IV in 2, and class V in 3 patients. Holter monitoring technique did not show the arrhythmias in 8 patients. Daily adrenaline and noradrenaline excretion with the urine was within the normal values (3.2-30.8 ug and 0.2-16.2 ug, respectively) in all examined patients. Daily urine noradrenaline was higher in patients with serious ventricular arrhythmias (Lown's class V) than mean values in the whole examined group.

摘要

该研究旨在评估通过尿中儿茶酚胺排泄量测定的肾上腺素能系统张力与二尖瓣脱垂患者室性心律失常发生率之间的可能关系。该研究纳入了20例患者(13名女性和7名男性,年龄在20至50岁之间;平均年龄 = 31.6岁),这些患者经病史、体格检查和超声心动图诊断为二尖瓣脱垂综合征。超声心动图显示,7例患者为二尖瓣前叶脱垂,8例患者为二尖瓣后叶脱垂,其余5例患者为二尖瓣双叶脱垂。采用范·欧拉和利沙伊科的荧光测定技术测量肾上腺素和去甲肾上腺素的每日排泄量。通过24小时心电图监测确定心律失常,并根据洛恩标准进行分类。1例患者出现I级室性早搏,5例为II级,1例为III级,2例为IV级,3例为V级。动态心电图监测技术显示8例患者未出现心律失常。所有接受检查的患者尿中肾上腺素和去甲肾上腺素的每日排泄量均在正常值范围内(分别为3.2 - 30.8微克和0.2 - 16.2微克)。严重室性心律失常(洛恩V级)患者的每日尿去甲肾上腺素高于整个检查组的平均值。

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