Allen W M, Matloff J M, Fishbein M C
Am J Cardiol. 1985 Feb 1;55(4):439-44. doi: 10.1016/0002-9149(85)90390-x.
Clinical and pathologic data were reviewed in 55 patients who had valve replacement for pure aortic regurgitation (AR) during a 6-year period. The clinical histories established the cause for AR in 34 cases: 11 rheumatic, 13 infective endocarditis, 4 congenital, 4 associated with aortic aneurysms and 2 the Marfan syndrome. In the valves from the other 21 patients, 13 had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucopolysaccharides and cystic change. Myxoid degeneration was also the primary pathologic abnormality in the 2 patients with the Marfan's syndrome, in 3 patients with a history of rheumatic disease and in 1 patient with a history of infective endocarditis. The patients with myxoid degeneration of uncertain origin were predominantly elderly (average age 63 years), had a long-standing history of systemic hypertension (77%) and had coronary artery disease (46%); 85% were male. In these patients the replacement valves were not larger than those of the other groups studied, indicating that dilatation of the aortic anulus was not a significant factor in the pathogenesis of the valve disease. These findings indicate that myxoid degeneration of the aortic valve is common (36% of all valves examined) and, in many cases, may be secondary to long-standing systemic hypertension.
对55例在6年期间因单纯主动脉瓣反流（AR）接受瓣膜置换术的患者的临床和病理资料进行了回顾。临床病史明确了34例AR的病因：风湿性11例、感染性心内膜炎13例、先天性4例、与主动脉瘤相关4例、马方综合征2例。在另外21例患者的瓣膜中，13例有黏液样变性，定义为瓣膜纤维层显著破坏并被酸性黏多糖替代以及出现囊性改变。黏液样变性也是2例马方综合征患者、3例有风湿病史患者和1例有感染性心内膜炎病史患者的主要病理异常。病因不明的黏液样变性患者以老年人为主（平均年龄63岁），有长期系统性高血压病史（77%）且有冠状动脉疾病（46%）；85%为男性。在这些患者中，置换瓣膜不比其他研究组的瓣膜大，表明主动脉瓣环扩张不是瓣膜病发病机制中的重要因素。这些发现表明主动脉瓣黏液样变性很常见（占所有检查瓣膜的36%），并且在许多情况下，可能继发于长期系统性高血压。
