Tomov I, Todorova M, Shabani R
Vutr Boles. 1985;24(3):61-71.
The diagnostic sensitivity, specificity and predicting accuracy of the various alterations, established by one-dimensional echocardiography (M-EchoC) were determined in 23 patients with rupture of mitral chordae. The diagnosis of mitral insufficiency, resulting from chordal rupture was confirmed at operation, with angiocardiography and/or bi-dimensional echocardiography. Almost all MEchoC alterations were with a relatively low sensitivity (10-50%), high specificity (60-100%) and moderately high predicting accuracy (50-80%). Of more essential diagnostic significance--moderate sensitivity and high specificity with high predictive accuracy, are the following alterations: systolic fibrillation of mitral valve, diastolic fibrillation of mitral valvular cusps, paradoxical (chaotic) movement of posterior mitral cusp during diastole. Very little sensitivity (10%) but with high specificity (100%) was established in pathological systolic echoes in the cavity of left auricle. In the majority of the cases, the rupture of mitral chordae induced grave mitral regurgitation, conditioning the various stages of cardiac insufficiency. Relatively rare is the light to moderately grave mitral regurgitation with stable hemodynamics and preserved functional capacity.
通过一维超声心动图（M - EchoC）确定的各种改变在23例二尖瓣腱索断裂患者中的诊断敏感性、特异性和预测准确性。由腱索断裂导致的二尖瓣关闭不全的诊断在手术中通过心血管造影和/或二维超声心动图得以证实。几乎所有的M - EchoC改变敏感性相对较低（10 - 50%），特异性较高（60 - 100%），预测准确性中等偏高（50 - 80%）。具有更重要诊断意义——中等敏感性、高特异性且预测准确性高的改变如下：二尖瓣收缩期震颤、二尖瓣瓣叶舒张期震颤、二尖瓣后叶在舒张期的矛盾（紊乱）运动。左心房腔内病理性收缩期回声的敏感性极低（10%），但特异性高（100%）。在大多数病例中，二尖瓣腱索断裂导致严重的二尖瓣反流，引发不同阶段的心功能不全。轻度至中度严重的二尖瓣反流伴稳定的血流动力学和保留的功能能力相对少见。
