Leibundgut Gregor, Bernheim Alain M
University Hospital Basel, Basel, Switzerland.
Eur J Echocardiogr. 2010 Apr;11(3):E6. doi: 10.1093/ejechocard/jep186. Epub 2009 Nov 20.
The authors report the case of a 77-year-old male patient with sinus rhythm and a first-degree atrioventricular (AV) block who was referred for echocardiographic follow-up 18 years after aortic valve replacement. Left ventricular systolic function as well as the function of the aortic prosthesis was normal. Systolic mitral regurgitation (MR) was virtually absent, but isolated late diastolic MR was detected by colour Doppler imaging. Coincidental to the occurrence of diastolic MR, a second late diastolic forward flow in the pulmonary veins was observed. Therefore, during the prolonged left atrial relaxation caused by first-degree AV block, the left atrial pressure drops below the pressure in both adjacent chambers in late diastole, resulting in both late diastolic MR and a second diastolic pulmonary venous forward flow.
作者报告了一例77岁男性患者，该患者为窦性心律，存在一度房室传导阻滞，在主动脉瓣置换术后18年接受超声心动图随访。左心室收缩功能以及主动脉人工瓣膜功能正常。几乎不存在收缩期二尖瓣反流（MR），但彩色多普勒成像检测到孤立的舒张晚期MR。在舒张期MR出现的同时，观察到肺静脉出现第二次舒张晚期正向血流。因此，在一度房室传导阻滞导致左心房舒张期延长期间，左心房压力在舒张晚期降至低于相邻两个腔室的压力，从而导致舒张晚期MR和第二次舒张期肺静脉正向血流。
