Boschat J, Le Mehaute H, Le Potier J, Roriz R, Gilard M, Bergez C, Etienne Y, Blanc J J, Penther P
Services de Cardiologie, CHU Morvan, Brest.
Ann Cardiol Angeiol (Paris). 1990 Feb;39(2):79-82.
Left atrial hypertrophy (LAH) was noted from the electrocardiograms of 72 of 98 adult patients (81%) who underwent hemodynamic evaluation of calcified aortostenosis (CAS). The relations between LAH and clinical, echographic and hemodynamic findings are specified. The frequency of LAH was not higher in cases of a history of hypertension, angina pectoris, lipothymia or exercise-induced syncope. In contrast, dyspnea was more frequently associated with LAH (84%) than not (17%). An approximately linear relation was seen between LAH and the mean pulmonary capillary pressure, the mean rate of circumferential decrease (RCF), the coefficient of muscle rigidity (ks of Mirsky), the left ventricular mass (LVM) and the left ventricle-aorta gradient. LAH is, therefore, a frequent sign in patients presenting CAS. Its origin is multifactorial, with a predominance of increased mean capillary pressure in cases of clinical signs of poor safety.
在对98例钙化性主动脉瓣狭窄(CAS)患者进行血流动力学评估的成年患者中,有72例(81%)的心电图显示左心房肥大(LAH)。明确了LAH与临床、超声心动图和血流动力学结果之间的关系。有高血压、心绞痛、晕厥或运动诱发晕厥病史的患者中,LAH的发生率并不更高。相比之下,呼吸困难与LAH相关的频率更高(84%),而非LAH的频率为17%。LAH与平均肺毛细血管压、平均圆周缩短率(RCF)、肌肉僵硬度系数(米尔斯基ks)、左心室质量(LVM)和左心室-主动脉梯度之间存在近似线性关系。因此,LAH是CAS患者的常见体征。其起源是多因素的,在安全性差的临床体征情况下,平均毛细血管压升高占主导地位。