Wigle E D, Rakowski H
Department of Medicine, Toronto General Hospital, Canada.
Z Kardiol. 1987;76 Suppl 3:61-8.
In obstructive hypertrophic cardiomyopathy (muscular or hypertrophic subaortic stenosis), there is rapid early systolic ejection through an outflow tract that is narrowed by ventricular septal hypertrophy. This results in Venturi forces acting on the mitral leaflets, which cause mitral leaflet systolic anterior motion. Subsequent mitral leaflet-septal contact results in obstruction to left ventricular outflow and concomitant mitral regurgitation. Evidence is provided that the subaortic pressure gradient in obstructive hypertrophic cardiomyopathy reflects true obstruction to left ventricular outflow. It is important to distinguish this truly obstructive subaortic pressure gradient, due to mitral leaflet-septal contact, from an early systolic impulse gradient, as well as from the intraventricular pressure difference that may be encountered in midventricular obstruction or cavity obliteration.
在梗阻性肥厚型心肌病（肌性或肥厚性主动脉瓣下狭窄）中，早期收缩期射血通过因室间隔肥厚而变窄的流出道迅速进行。这会产生作用于二尖瓣叶的文丘里力，导致二尖瓣叶收缩期前向运动。随后二尖瓣叶与室间隔接触导致左心室流出道梗阻并伴有二尖瓣反流。有证据表明，梗阻性肥厚型心肌病中的主动脉瓣下压力梯度反映了左心室流出道的真正梗阻。区分这种由于二尖瓣叶与室间隔接触导致的真正梗阻性主动脉瓣下压力梯度与早期收缩期冲动梯度以及可能在心室中部梗阻或腔隙闭塞中遇到的心室内压差非常重要。
