Pape L A, Price J M, Alpert J S, Ockene I S, Weiner B H
University of Massachusetts Medical Center, Division of Cardiovascular Medicine, Worcester.
Cardiology. 1991;78(4):297-303. doi: 10.1159/000174808.
4,071 consecutive cardiac catheterizations were reviewed retrospectively to obtain 56 cases of pure mitral regurgitation among whom chest X-ray, electrocardiography and echocardiography had been performed within 10 days of catheterization. Mitral regurgitation was mild to moderate (1-2+) in 7 of the 56 cases while 49 had more severe regurgitation (3-4+). Left atrial size as measured by echocardiography was found to be enlarged in all but 2 cases. A positive correlation between left atrial size and severity of mitral regurgitation, irrespective of the height of the pulmonary capillary wedge pressure V wave was demonstrated. There was no demonstrable, predictive relationship between left atrial size and pulmonary capillary wedge pressure or electrocardiographic or chest X-ray findings. We conclude that knowledge of left atrial size is predictive of the severity of mitral regurgitation; however, it is not possible to predict the pulmonary capillary wedge pressure or height of the V waves based on a knowledge of left atrial dilatation in patients with pure mitral regurgitation.
回顾性分析了4071例连续的心导管检查病例，从中获得56例单纯二尖瓣反流患者，这些患者在导管检查后10天内进行了胸部X线、心电图和超声心动图检查。56例患者中，7例二尖瓣反流为轻度至中度（1-2+），49例反流更严重（3-4+）。超声心动图测量的左心房大小，除2例患者外，其余均增大。研究表明，无论肺毛细血管楔压V波的高度如何，左心房大小与二尖瓣反流严重程度之间均呈正相关。左心房大小与肺毛细血管楔压、心电图或胸部X线检查结果之间无明显的预测关系。我们得出结论，了解左心房大小可预测二尖瓣反流的严重程度；然而，对于单纯二尖瓣反流患者，仅根据左心房扩张情况无法预测肺毛细血管楔压或V波高度。
