Attari M, Legrand M, Philippe C, Rosak P
Pôle Neurocardiologie, centre hospitalier du Mans, 194, avenue Rubillard, 72037 Le Mans cedex 9, France.
Ann Cardiol Angeiol (Paris). 2013 Aug;62(4):278-81. doi: 10.1016/j.ancard.2011.09.008. Epub 2011 Oct 19.
We here report the case of a 67-year-old woman with moderate mitral regurgitation without significant structural abnormalities that get worse during severe recurrent heart failures and preserved ejection fraction with concomitant paroxysmal atrial fibrillation. Atrial fibrillation became permanent and despite a well-controlled cardiac frequency, new heart failure episodes occurred. Exercise doppler echocardiography showed that the mechanism of this mitral regurgitation was a two leaflet mitral tenting. We discuss here the different mechanisms that could induce these kinds of mitral regurgitation with excessive tenting. We emphasize the interest of early detection by exercise doppler echocardiography even when a triggering factor like atrial fibrillation seems to be involved. We also discuss the interest of mitral valve replacement for these patients.
我们在此报告一例67岁女性病例，该患者患有中度二尖瓣反流，无明显结构异常，在严重复发性心力衰竭期间病情加重，射血分数保留，同时伴有阵发性心房颤动。心房颤动转为永久性，尽管心率控制良好，但仍出现新的心力衰竭发作。运动多普勒超声心动图显示，这种二尖瓣反流的机制是二尖瓣双叶帐篷样改变。我们在此讨论可能导致这种过度帐篷样改变的二尖瓣反流的不同机制。我们强调即使存在心房颤动等触发因素，运动多普勒超声心动图早期检测的重要性。我们还讨论了这些患者进行二尖瓣置换术的意义。
