Onishchenko E F, Krylov A A
Ter Arkh. 1991;63(4):17-22.
Clinical and echocardiographic studies were carried out in 100 young men (mean age 18.0 +/- 3.0 years) with "harmless" murmur (HM). 20 young men (mean age 17.0 +/- 2.0 years) were examined as control. In these men, murmur could not be detected both at rest and after 15 squattings and the hyperventilation test. No relationship was discovered between the murmur intensity and gravity of heart hyperdynamia, although in persons with HM, the predominance of hyperdynamia could be observed. It is believed that the intensity of HM is due to the morphofunctional features of the cardiac structures. The chordal apparatus of the heart is viewed as one of them. In 37% of persons with HM, echocardiography revealed a phenomenon of the "fluttering" chorda, which lies in diastolic-systolic hypermobility of one of the commonly attached chordae of the mitral valve because of its excessive length and weak tonic tension. That phenomenon is usually associated with so-called Steele's murmur. It is concluded that via the phenomenon of the "fluttering" of the chorda of the mitral valve there may occur labile and, in some cases, of "musical" non-regurgitation systolic murmur in local dysfunction of the papillary muscles.
对100名患有“无害性”杂音（HM）的年轻男性（平均年龄18.0±3.0岁）进行了临床和超声心动图研究。选取20名年轻男性（平均年龄17.0±2.0岁）作为对照进行检查。在这些男性中，静息时、15次下蹲后及过度通气试验时均未检测到杂音。尽管在患有HM的人群中可观察到心脏动力亢进占优势，但未发现杂音强度与心脏动力亢进严重程度之间存在关联。据信，HM的强度归因于心脏结构的形态功能特征。心脏的腱索装置被视为其中之一。在37%的患有HM的人群中，超声心动图显示存在“颤动”腱索现象，这是由于二尖瓣常见附着腱索之一过长且张力减弱，导致其在舒张期 - 收缩期活动过度。该现象通常与所谓的斯蒂尔杂音相关。得出的结论是，通过二尖瓣腱索的“颤动”现象，在乳头肌局部功能障碍时可能会出现不稳定的，在某些情况下为“音乐性”的非反流性收缩期杂音。
