Kashida M, Kuwako K, Yamaguchi T, Furuta S
Center for Cardiovascular Disease, Mitsui Memorial Hospital, Tokyo.
J Cardiol. 1989 Mar;19(1):177-85.
This study was undertaken to determine the etiology of non-rheumatic aortic regurgitation (AR) by two-dimensional echocardiography. Dimensions of the aortic root at the levels of the surgical aortic ring (ARDs), sinus of Valsalva (AOD), and anatomical aortic ring (ARD) were measured in 23 patients who underwent aortic valve replacement due to AR with idiopathic aortic root dilatation, in 15 hypertensive patients without AR and in 15 normal controls. The 23 patients with AR were classified as annuloaortic ectasia (AAE) (seven cases) and non-AAE (16 cases) groups. In the AAE group, the ascending aorta and aortic root were markedly dilated and had a pear-like configuration on aortography while the aorta had a normal configuration in the non-AAE group. ARDs was significantly larger in the non-AAE and AAE groups than in the hypertension and normal control groups. AOD and ARD were significantly larger in the hypertension and non-AAE groups than in the normal controls, and those in the AAE group were greater than those in any other group. The end-diastolic shape of the aortic valve in the long-axis view was "Y" shaped in the normal control and hypertension groups, "T" shaped in the non-AAE group, and the patients with AAE showed no cuspal coaptation. AR due to aortic ring dilatation, mainly reported by pathologists, were due to marked degree of ARD dilatation. However, our two-dimensional echocardiographic study showed that moderate dilatation of the entire aortic root in the non-AAE group seemed to be an important factor in the genesis of AR, even without dilatation of ARD.
本研究旨在通过二维超声心动图确定非风湿性主动脉瓣关闭不全（AR）的病因。对23例因AR伴特发性主动脉根部扩张而接受主动脉瓣置换术的患者、15例无AR的高血压患者和15例正常对照者，测量手术主动脉环（ARDs）、主动脉瓣窦（AOD）和解剖主动脉环（ARD）水平的主动脉根部尺寸。23例AR患者分为瓣环主动脉扩张（AAE）组（7例）和非AAE组（16例）。在AAE组中，升主动脉和主动脉根部明显扩张，主动脉造影显示呈梨形，而非AAE组主动脉形态正常。非AAE组和AAE组的ARDs明显大于高血压组和正常对照组。高血压组和非AAE组的AOD和ARD明显大于正常对照组，且AAE组的AOD和ARD大于其他任何组。正常对照组和高血压组在长轴视图中主动脉瓣舒张末期形态为“Y”形，非AAE组为“T”形，AAE组患者无瓣叶对合。病理学家主要报道的由主动脉环扩张引起的AR是由于ARD明显扩张。然而，我们的二维超声心动图研究表明，非AAE组整个主动脉根部的中度扩张似乎是AR发生的一个重要因素，即使ARD没有扩张。
