Meinertz T, Kasper W, Bödecker W, Hofmann T, Zehender M, Geibel A, Treese N, Just H
Medizinische Universitätsklinik Freiburg.
Z Kardiol. 1987 Jul;76(7):421-7.
The incidence and severity of ventricular arrhythmias were compared with hemodynamic findings of cardiac catheterization, in 160 patients with mitral and aortic valve disease. All patients underwent right and left heart catheterization, as well as M-mode and 2D-echocardiography, and 24-hour ambulatory electrocardiographic monitoring. Out of 160 patients, 68 had mitral valve disease and 92 had aortic valve disease. In mitral regurgitation the degree and frequency of ventricular arrhythmias showed a positive correlation to the degree of regurgitation (rs = 0.44, rs = 0.56, respectively) and a negative correlation to left ventricular ejection fraction (rs = -0.49, rs = -0.57) and to cardiac index (rs = 0.48, rs = 0.53). In aortic valve disease the incidence and severity of ventricular arrhythmias were not related to the type of valve lesion, to the transvalvular pressure gradient nor to the degree of regurgitation. In aortic stenosis, the degree of arrhythmia showed a negative correlation to left ventricular ejection fraction (rs = 0.55) and a positive correlation to left ventricular endsystolic volume index (rs = 0.40) and to peak systolic left ventricular wall stress (rs = 0.59). In aortic regurgitation the number of ventricular arrhythmias showed a negative correlation to left ventricular ejection fraction (rs = -0.43) and a positive correlation to left ventricular endsystolic volume index (rs = 0.43) and to peak systolic left ventricular wall stress (rs = 0.37). These data demonstrate that the incidence and severity of ventricular arrhythmias, in patients with aortic valve disease and mitral regurgitation, are strongly associated with the impairment of left ventricular function.
对160例二尖瓣和主动脉瓣疾病患者的室性心律失常发生率和严重程度与心脏导管检查的血流动力学结果进行了比较。所有患者均接受了右心和左心导管检查、M型和二维超声心动图检查以及24小时动态心电图监测。160例患者中，68例患有二尖瓣疾病，92例患有主动脉瓣疾病。在二尖瓣反流中，室性心律失常的程度和频率与反流程度呈正相关（rs分别为0.44和0.56），与左心室射血分数呈负相关（rs分别为-0.49和-0.57），与心脏指数呈正相关（rs分别为0.48和0.53）。在主动脉瓣疾病中，室性心律失常的发生率和严重程度与瓣膜病变类型、跨瓣压力梯度及反流程度无关。在主动脉瓣狭窄中，心律失常程度与左心室射血分数呈负相关（rs为0.55），与左心室收缩末期容积指数呈正相关（rs为0.40），与左心室壁收缩期峰值应力呈正相关（rs为0.59）。在主动脉瓣反流中，室性心律失常的数量与左心室射血分数呈负相关（rs为-0.43），与左心室收缩末期容积指数呈正相关（rs为0.43），与左心室壁收缩期峰值应力呈正相关（rs为0.37）。这些数据表明，主动脉瓣疾病和二尖瓣反流患者的室性心律失常发生率和严重程度与左心室功能损害密切相关。
