Fujii J
Cardiovascular Institute, Tokyo.
J Cardiogr Suppl. 1986(11):57-72.
Electrocardiographic signs of mitral valve prolapse are essentially non-specific. Diagnosis must be based on the other methods, but whenever the diagnosis was established, the electrocardiographic abnormalities may have a certain significance to predict the natural course and prognosis. The reported results and those of our series of 111 cases were compared in detail. Resting and exercise electrocardiography of our series revealed no definite tendency of ST-T changes, arrhythmias and other abnormalities in cases with prolapse except a few signs. When the abnormalities were present, they were not related to the severity of prolapse, but premature ventricular contractions were more frequently observed in severe cases. Atrial fibrillation was observed in higher frequency in cases with mitral regurgitation. The other abnormalities were not conclusive to verify previous studies. When compared to 19 cases with neurocirculatory asthenia comfirmed by clinical tests including angiography, the similarity of electrocardiographic abnormalities was observed in many aspects, but arrhythmias were much more common in cases with mitral valve prolapse. On the other hand, exercise test was positive more frequently in cases with neurocirculatory asthenia. No conclusion was established as to the sites of prolapse and electrocardiographic abnormalities.
二尖瓣脱垂的心电图表现本质上是非特异性的。诊断必须基于其他方法，但一旦确诊，心电图异常对于预测自然病程和预后可能具有一定意义。对已报道的结果与我们的111例病例系列结果进行了详细比较。我们系列病例的静息和运动心电图显示，除了少数体征外，脱垂病例中ST-T改变、心律失常及其他异常无明确趋势。当存在异常时，它们与脱垂的严重程度无关，但在严重病例中更常观察到室性早搏。二尖瓣反流病例中房颤的发生率较高。其他异常对于证实既往研究并无定论。与经包括血管造影在内的临床检查确诊的19例神经循环衰弱病例相比，在许多方面观察到心电图异常具有相似性，但二尖瓣脱垂病例中心律失常更为常见。另一方面，神经循环衰弱病例运动试验阳性更为频繁。关于脱垂部位与心电图异常之间尚未得出结论。
