Unterberg R, Römmich P, Völker W, Mauser M, Karsch K R
Abteilung Innere Medizin III, Universität Tübingen.
Z Kardiol. 1987 Dec;76(12):761-9.
To investigate the effect of chronic left ventricular enlargement on right ventricular geometry and function, biplane cineventriculograms were analyzed in 23 patients with aortic regurgitation (AR) and in 17 patients with mitral regurgitation (MR). Left ventricular end-diastolic volume indices (LVEDVI) were elevated and significantly (p less than 0.05) different in patients with aortic regurgitation (AR) (190.2 +/- 65.2 ml/m2) and mitral regurgitation (MR) (148.7 +/- 40.1 ml/m2). Right ventricular end-diastolic volume indices (RVEDVI), however, were comparable and within the normal range (AR: 96.6 +/- 18.3 ml/m2, MR: 100.2 +/- 33.7 ml/m2). Mean pulmonary artery pressure was significantly (p less than 0.05) higher in patients with mitral regurgitation with 24.7 +/- 12.8 mm Hg (AR: 17.5 +/- 6.6 mm Hg). Six patients with mitral insufficiency had concomitant tricuspid valve insufficiency. In five out of six patients with tricuspid insufficiency, right ventricular afterload was significantly elevated. Only in patients with mitral regurgitation was a significant correlation (r) between left and right ventricular end-diastolic volume index found (RVEDVI = 0.7 X LVEDVI +1, r = 0.80). Moreover, in patients with MR, left ventricular end-diastolic volume index correlated with right ventricular end-systolic volume index (RVESVI = 0.4 X LVEDVI -8, r = 0.73). Right ventricular ejection fraction was significantly different (p less than 0.05) between patients with aortic and mitral insufficiency (AR: 53.7 +/- 8.9%, MR: 46.7 +/- 10.7%). Particularly in patients with normal left ventricular ejection fraction (greater than 50%) and mitral regurgitation, the incidence of a reduced right ventricular ejection fraction (less than 50%) was significantly higher (p less than 0.01) compared to patients with aortic regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究慢性左心室扩大对右心室几何形态及功能的影响，对23例主动脉瓣反流（AR）患者和17例二尖瓣反流（MR）患者的双平面电影心室造影进行了分析。主动脉瓣反流（AR）患者（190.2±65.2 ml/m²）和二尖瓣反流（MR）患者（148.7±40.1 ml/m²）的左心室舒张末期容积指数（LVEDVI）升高且差异有统计学意义（p＜0.05）。然而，右心室舒张末期容积指数（RVEDVI）相当且在正常范围内（AR：96.6±18.3 ml/m²，MR：100.2±33.7 ml/m²）。二尖瓣反流患者的平均肺动脉压显著更高（p＜0.05），为24.7±12.8 mmHg（AR：17.5±6.6 mmHg）。6例二尖瓣关闭不全患者合并三尖瓣关闭不全。在6例三尖瓣关闭不全患者中的5例，右心室后负荷显著升高。仅在二尖瓣反流患者中，左、右心室舒张末期容积指数之间存在显著相关性（r）（RVEDVI = 0.7×LVEDVI +1，r = 0.80）。此外，在二尖瓣反流患者中，左心室舒张末期容积指数与右心室收缩末期容积指数相关（RVESVI = 0.4×LVEDVI -8，r = 0.73）。主动脉瓣和二尖瓣关闭不全患者之间的右心室射血分数有显著差异（p＜0.05）（AR：53.7±8.9%，MR：46.7±10.7%）。特别是在左心室射血分数正常（＞50%）且有二尖瓣反流的患者中，右心室射血分数降低（＜50%）的发生率比主动脉瓣反流患者显著更高（p＜0.01）。（摘要截断于250字）
