Rao P S, Mukhopadhyay S, Tandon R, Shrivastava S
Pediatr Cardiol. 1986;6(6):293-7.
A total of 18 patients with pure rheumatic mitral stenosis between the ages of eight and 14 years (average 11.8 years) were studied. Left ventricular angiograms in the right anterior oblique view were obtained in each. Moderate to severe pulmonary arterial hypertension was present in all but one. The mean left ventricular end-systolic volume index was 25.4 +/- 8.5 ml/m2; it was increased in five patients. The mean left ventricular end-diastolic volume index was 64 +/- 13.5 ml/m2. It was normal in all except one patient, in whom it was increased to 91 ml/m2. The left ventricular stroke volume index, 39.6 +/- 8.8 ml/m2, was within the normal range. The left ventricular stroke volume index, 39.6 +/- 8.8 ml/m2, was within the normal range. The mean left ventricular ejection fraction was 0.61 +/- 0.09 ml, with a range of 0.44-0.72. The mean left ventricular ejection fraction was lower than normal (P less than 0.05). The ejection fraction was low in five of the 18 patients. Four of the five patients with an ejection fraction below 0.60 had severe pulmonary arterial hypertension. There was no correlation between the ejection fraction and left atrial pressure or the mitral valve area. Segmental contraction analysis in the five patients with a low ejection fraction showed global hypokinesia in four and segmental hypokinesia, involving predominantly the posterobasal segment, in one patient. Our study suggests that even children with pure mitral stenosis may have left ventricular dysfunction in the absence of active carditis.
对18例年龄在8至14岁（平均11.8岁）的单纯风湿性二尖瓣狭窄患者进行了研究。对每例患者均进行了右前斜位左心室血管造影。除1例患者外，其余患者均存在中度至重度肺动脉高压。左心室收缩末期容积指数平均为25.4±8.5ml/m²；5例患者该指数升高。左心室舒张末期容积指数平均为64±13.5ml/m²。除1例患者该指数升高至91ml/m²外，其余患者均正常。左心室每搏量指数为39.6±8.8ml/m²，在正常范围内。左心室每搏量指数为39.6±8.8ml/m²，在正常范围内。左心室射血分数平均为0.61±0.09，范围为0.44 - 0.72。左心室射血分数低于正常（P<0.05）。18例患者中有5例射血分数较低。射血分数低于0.60的5例患者中有4例患有重度肺动脉高压。射血分数与左心房压力或二尖瓣面积之间无相关性。对5例射血分数较低的患者进行节段性收缩分析，结果显示4例为整体运动减弱，1例为节段性运动减弱，主要累及后基底段。我们的研究表明，即使是单纯二尖瓣狭窄的儿童，在无活动性心肌炎的情况下也可能存在左心室功能障碍。
