Lin W W, Chang F J, Hwang J F, Tsai Z H, Lee D Y, Chen Y T
Division of Cardiology, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1990 Nov;46(5):259-64.
Vasodilators cause the earlier occurrence of click and prolong the duration of regurgitation murmur in mitral valve prolapse (MVP), meanwhile, they also decrease the intensity of murmur. To investigate the net effects of vasodilators on mitral regurgitation (MR) caused by MVP, we studied the hemodynamic responses to intravenous hydralazine in 10 patients with MVP and associated MR. The results showed that hydralazine reduced systemic vascular resistance by 28% (1705 +/- 307 to 1223 +/- 227 dyne-sec-cm5 p less than 0.001) and produced a 30% increase in cardiac output (4.4 +/- 0.7 to 5.7 +/- 0.7 l/min, p less than 0.001). The forward stroke volume increased by 18% (56 +/- 12 to 66 +/- 11 ml, p less than 0.001), while regurgitant stroke volume fell by 14% (46 +/- 22 to 40 +/- 23 ml, p less than 0.05), with a resultant slight fall in pulmonary capillary wedge v wave (13 +/- 5 to 11 +/- 3 mmHg, p = 0.05). We thus suggest that hydralazine has beneficial hemodynamic effects on MVP with regurgitation, and may be effective in the treatment of these patients.
血管扩张剂可使二尖瓣脱垂（MVP）患者更早出现喀喇音，并延长反流性杂音的持续时间，同时，它们还会降低杂音的强度。为了研究血管扩张剂对MVP所致二尖瓣反流（MR）的总体影响，我们对10例MVP合并MR患者静脉注射肼苯哒嗪后的血流动力学反应进行了研究。结果显示，肼苯哒嗪使体循环血管阻力降低了28%（从1705±307降至1223±227达因·秒·厘米⁻⁵，p<0.001），心输出量增加了30%（从4.4±0.7升至5.7±0.7升/分钟，p<0.001）。前向搏出量增加了18%（从56±12增至66±11毫升，p<0.001），而反流搏出量下降了14%（从46±22降至40±23毫升，p<0.05），肺毛细血管楔压v波略有下降（从13±5降至11±3毫米汞柱，p=0.05）。因此，我们认为肼苯哒嗪对合并反流的MVP患者具有有益的血流动力学作用，可能对这些患者的治疗有效。
