Díaz R A, Nihoyannopoulos P, Oakley C M
Rev Med Chil. 1989 Nov;117(11):1232-5.
In order to assess the incidence of valvular regurgitation in dilated cardiomyopathy, 26 patients, aged 32 to 61 years, were prospectively studied by two-dimensional echocardiography and color doppler flow imaging. Patients were in New York Heart Association functional class III or IV. All patients underwent coronary angiography which excluded coronary artery disease. Contrast ventriculography showed a dilated and hypocontractile left ventricle and right ventricular endomyocardial biopsy excluded specific heart muscle disease. Regurgitant flows were observed as a mosaic pattern and were semiquantitatively classified as mild, moderate or severe according to the width and depth of the regurgitant jets. Twenty-six (100%) patients had mitral regurgitation, 9 (34,6%) had aortic regurgitation, 12 (46.2%) had tricuspid regurgitation and 11 (42.3%) had pulmonary regurgitation. Multivalvular regurgitation was observed in 77% of patients occurring across two, three, or all four valves in 30.8%; 30.8% and 15.4% of patients, respectively. Two dimensional echocardiography color flow imaging shows a high prevalence of multivalvular regurgitation in patients with dilated cardiomyopathy.
为了评估扩张型心肌病患者瓣膜反流的发生率,我们对26例年龄在32至61岁之间的患者进行了前瞻性二维超声心动图和彩色多普勒血流成像研究。患者均处于纽约心脏协会心功能Ⅲ级或Ⅳ级。所有患者均接受冠状动脉造影以排除冠状动脉疾病。对比心室造影显示左心室扩张且收缩功能减退,右心室心内膜活检排除了特异性心肌病。反流表现为彩色镶嵌血流信号,并根据反流束的宽度和深度将其半定量分为轻度、中度或重度。26例(100%)患者存在二尖瓣反流,9例(34.6%)存在主动脉瓣反流,12例(46.2%)存在三尖瓣反流,11例(42.3%)存在肺动脉瓣反流。77%的患者存在多瓣膜反流,其中30.8%的患者累及两个瓣膜,30.8%的患者累及三个瓣膜,15.4%的患者累及所有四个瓣膜。二维超声心动图彩色血流成像显示扩张型心肌病患者多瓣膜反流的发生率较高。