Mirrakhimov M M, Tilis Iu A, Baltabaev T B
Kardiologiia. 1985 Apr;25(4):20-4.
Thirty-five patients with primary large-focal myocardial infarction (MI) were investigated, with mitral incompetence diagnosed in 19. All patients underwent clinical investigation, including electro-, phono- and echocardiography, and tetrapolar chest rheoplethysmography. Direct measurements of pulmonary arterial pressure were made in 11 patients. The investigations were carried out prior to, and at the peak of nitroglycerin action. It was shown that mitral regurgitation was associated with increased incidence and severity of heart failure during the acute stage of MI. Such patients showed low cardiac and stroke index values, a more marked overstrain of the left atrium and left ventricle, and high pulmonary arterial pressure. Intravenous administration of nitroglycerin improves intracardiac hemodynamics in acute MI, its effect being more pronounced in patients with mitral incompetence. Early and prolonged nitroglycerin treatment is indicated in cases of acute MI with mitral incompetence.
对35例原发性大面积局灶性心肌梗死（MI）患者进行了研究，其中19例诊断为二尖瓣关闭不全。所有患者均接受了临床检查，包括心电图、心音图、超声心动图和四极胸壁血流容积描记法。11例患者进行了肺动脉压的直接测量。在硝酸甘油作用之前和作用高峰时进行了这些检查。结果表明，二尖瓣反流与MI急性期心力衰竭的发生率增加和严重程度相关。这类患者的心输出量和每搏输出量较低，左心房和左心室的过度负荷更为明显，肺动脉压较高。静脉注射硝酸甘油可改善急性MI时的心内血流动力学，其作用在二尖瓣关闭不全患者中更为明显。对于急性MI合并二尖瓣关闭不全的病例，建议早期和长期使用硝酸甘油治疗。
