Kahaly G, Erbel R, Mohr-Kahaly S, Zenker G, von Olshausen K, Krause U, Beyer J
Dtsch Med Wochenschr. 1987 Feb 13;112(7):248-53. doi: 10.1055/s-2008-1068038.
The prevalence of mitral valve prolapse was investigated in 60 patients with Graves' disease (42 with ophthalmopathy) and in 20 patients with toxic nodular goitre. 2410 patients from the echocardiography laboratory served as controls. Standard M-mode, Doppler and two-dimensional echocardiography were performed. Mitral valve prolapse was defined as a systolic buckling greater than or equal to 3 mm. In patients with thyroid disease HLA antigens were determined. Patients with Graves' disease showed a significantly higher incidence of mitral valve prolapse (36/60, 60%) compared to the group with toxic nodular goitre (2/20, 10%) and to controls (238/2410, 9,9%) (P less than 0.0001). 16 of 36 patients had a prolapse of the anterior, in 3 of 36 the posterior leaflet was involved and 17 of 36 had both. Mean systolic buckling was 4.3 +/- 1.5 mm. 28 of 42 patients with ophthalmopathy (67%) showed a mitral valve prolapse. 20 of 60 patients (33.3%) with Graves' disease but none in the goitre group showed a thickened myxomatous valve (P less than 0.001). Thyroid function did not influence the incidence and intensity of the prolapse. The HLA phenotypes B8 were seen in 22 of 36 and DR3 in 24 of 36 patients with mitral valve prolapse. Since thyroid function was comparable in both groups an involvement of the mitral valve in an autoimmune process affecting several organs can be considered probable.
对60例格雷夫斯病患者（42例伴有眼病）和20例毒性结节性甲状腺肿患者的二尖瓣脱垂患病率进行了调查。来自超声心动图实验室的2410名患者作为对照。进行了标准M型、多普勒和二维超声心动图检查。二尖瓣脱垂定义为收缩期瓣叶弯曲≥3mm。对甲状腺疾病患者测定了HLA抗原。与毒性结节性甲状腺肿组（2/20，10%）和对照组（238/2410，9.9%）相比，格雷夫斯病患者的二尖瓣脱垂发生率显著更高（36/60，60%）（P<0.0001）。36例患者中，16例为前叶脱垂，3例为后叶脱垂，17例为前后叶均脱垂。平均收缩期瓣叶弯曲为4.3±1.5mm。42例眼病患者中有28例（67%）出现二尖瓣脱垂。60例格雷夫斯病患者中有20例（33.3%）出现黏液瘤样瓣膜增厚，而甲状腺肿组无一例出现（P<0.001）。甲状腺功能不影响脱垂的发生率和严重程度。36例二尖瓣脱垂患者中，22例出现HLA表型B8，24例出现DR3。由于两组甲状腺功能相当，因此可以认为二尖瓣受累于影响多个器官的自身免疫过程是有可能的。
