Drăgulescu S I, Streian C, Velica A, Cristodorescu R, Abazid J, Nicolin M
Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Med Interna. 1989 Mar-Apr;41(2):135-42.
The present study investigates 16 patients with aortic regurgitation (AR), and 10 patients with mitral regurgitation (MR). Before operation, all the 26 patients had increased telediastolic and telesystolic diameters. The patients were divided into two groups, as a function of the postoperative values of the telediastolic diameter: group A--with the telediastolic diameter within normal limits; group B--with the persistence of the increased values of the telediastolic diameter. In the case of the patients with AR, the following postoperative situation was noticed: in group A: the peak systolic stress (PSS) was increased, the shortening fraction (SF) in the telesystolic stress (TSS) within normal limits; in group B: PSS and TSS were increased, and ST depressed. 8 months after the valvular correction, in group A: PSS, TSS and SF were normal; in group B: the changes in PSS and TSS continued and was lowered. In the case of the patients with MR, before operation, in group A: PSS was slightly increased while TSS and SF were normal; in group B: PSS was slightly increased, TSS, increased and SF depressed. 8 months after the surgical correction: in group A: PSS and SF decreased; in group B: echocardiographic changes continued. Therefore, in the group B patients with MR and AR, the persistence of the increased values of PSS, TSS leads to the postoperative decrease of SF (post-charge in excess).
本研究调查了16例主动脉瓣反流（AR）患者和10例二尖瓣反流（MR）患者。术前，所有26例患者的舒张末期和收缩末期直径均增大。根据舒张末期直径的术后值将患者分为两组：A组——舒张末期直径在正常范围内；B组——舒张末期直径持续增大。对于AR患者，术后情况如下：A组：收缩期峰值应力（PSS）升高，收缩末期应力（TSS）缩短分数（SF）在正常范围内；B组：PSS和TSS升高，ST段压低。瓣膜矫正8个月后，A组：PSS、TSS和SF正常；B组：PSS和TSS的变化持续且降低。对于MR患者，术前，A组：PSS略有升高，而TSS和SF正常；B组：PSS略有升高，TSS升高，SF降低。手术矫正8个月后：A组：PSS和SF降低；B组：超声心动图变化持续。因此，在B组的MR和AR患者中，PSS、TSS升高值的持续存在导致术后SF降低（过度负荷后）。
