Labovitz A J, Nelson J G, Windhorst D M, Kennedy H L, Williams G A
Am J Cardiol. 1985 Jan 1;55(1):133-7. doi: 10.1016/0002-9149(85)90314-5.
Doppler echocardiography is useful for detecting and quantifying mitral regurgitation (MR) and mitral stenosis (MS). To determine the prevalence of these abnormalities in patients with mitral anular calcium (MAC), 51 consecutive patients who had an echocardiographic diagnosis of MAC were examined by Doppler ultrasound. Transmitral flow was evaluated to determine the presence of MR or left ventricular inflow obstruction (MS) by continuous and pulsed-wave Doppler echocardiography. The severity of these hemodynamic abnormalities was quantitated by previously described techniques. Eleven patients (22%) had mild MR, 17 (33%) had moderate to severe MR and 4 (8%) had significant MS. Clinical findings such as a systolic murmur, evidence of congestive heart failure, and dyspnea on exertion were not helpful in distinguishing patients with no or mild MR from those who had moderate to severe MR. M-mode measured left atrial size was significantly larger (p less than 0.05) in patients with moderate to severe MR. This study suggests that MR is often associated with MAC, that MS is not a rare finding with MAC, and that Doppler echocardiography can quantitate these lesions in the elderly when symptoms are not specific and physical findings are inconclusive or absent.
多普勒超声心动图对于检测和量化二尖瓣反流（MR）及二尖瓣狭窄（MS）很有用。为了确定二尖瓣环钙化（MAC）患者中这些异常的患病率，对连续51例经超声心动图诊断为MAC的患者进行了多普勒超声检查。通过连续波和脉冲波多普勒超声心动图评估跨二尖瓣血流，以确定是否存在MR或左心室流入道梗阻（MS）。这些血流动力学异常的严重程度采用先前描述的技术进行定量。11例患者（22%）有轻度MR，17例（33%）有中度至重度MR，4例（8%）有显著MS。诸如收缩期杂音、充血性心力衰竭证据以及劳力性呼吸困难等临床发现，对于区分无MR或轻度MR的患者与中度至重度MR的患者并无帮助。中度至重度MR患者的M型测量左心房大小显著更大（p<0.05）。本研究提示，MR常与MAC相关，MS在MAC患者中并非罕见发现，并且当症状不特异且体格检查结果不确定或不存在时，多普勒超声心动图可对老年人的这些病变进行定量。
