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[慢性主动脉瓣关闭不全的随访研究]

[Follow-up studies in chronic aortic insufficiency].

作者信息

Klepzig H, Standke R, Baum R, Kunkel B, Maul F D, Hör G, Kaltenbach M

出版信息

Z Kardiol. 1985 Jun;74(6):348-52.

PMID:4024685
Abstract

In order to study the course of chronic aortic regurgitation 17 patients with various degrees of aortic valve incompetence were investigated twice with a time interval of 1.5 +/- 0.4 years. The following parameters were evaluated: NYHA class; electrocardiographic sum of the largest R-wave in V4-V6 plus the largest S-wave in V1-V3 (RS index); echocardiographic left ventricular end-diastolic diameter (EDD); roentgenographic heart volume (HV); scintigraphic left ventricular end-diastolic volume (EDV), regurgitated blood volume (RBV) and ejection fraction (EF). During the period of observation functional deterioration occurred in 5 cases, all suffering from moderate to severe aortic regurgitation. While EF did not change significantly (55 +/- 12% vs. 55 +/- 11%), all other parameters showed a significant increase: RS index 5.4 +/- 1.4 mVolt to 6.0 +/- 1.7 mVolt (p less than 0.01); EDD 6.3 +/- 0.7 to 6.8 +/- 0.9 cm (p less than 0.001); HV 1017 +/- 151 ml to 1099 +/- 261 ml (p less than 0.01); EDV 371 +/- 131 ml to 441 +/- 175 ml (p less than 0.001); RBV 117 +/- 57 ml to 151 +/- 77 ml (p less than 0.001). Cases with functional deterioration showed a higher initial EDV and EDD (487 +/- 143 vs. 322 +/- 93 ml, p less than 0.05; 7.1 +/- 0.7 vs. 6.1 +/- 0.5 cm, p less than 0.01). The increase of HV, EDV and RBV during the time of observation was higher than in the remaining patients (166 +/- 137 vs. 39 +/- 95 ml, p less than 0.05; 133 +/- 75 vs. 44 +/- 29 ml, p less than 0.01; 66 +/- 22 vs. 22 +/- 31 ml, p less than 0.01). On average it was less pronounced in cases with mild initial left ventricular dilation than in those with marked dilation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为研究慢性主动脉瓣反流的病程,对17例不同程度主动脉瓣关闭不全的患者进行了两次调查,时间间隔为1.5±0.4年。评估了以下参数:纽约心脏协会(NYHA)心功能分级;心电图V4 - V6导联最大R波与V1 - V3导联最大S波之和(RS指数);超声心动图左心室舒张末期内径(EDD);X线胸片心脏容积(HV);核素显像左心室舒张末期容积(EDV)、反流血量(RBV)和射血分数(EF)。观察期间,5例出现功能恶化,均为中重度主动脉瓣反流。虽然EF无显著变化(55±12%对55±11%),但所有其他参数均显著增加:RS指数从5.4±1.4毫伏增至6.0±1.7毫伏(p<0.01);EDD从6.3±0.7厘米增至6.8±0.9厘米(p<0.001);HV从1017±151毫升增至1099±261毫升(p<0.01);EDV从371±131毫升增至441±175毫升(p<0.001);RBV从117±57毫升增至151±77毫升(p<0.001)。功能恶化的病例初始EDV和EDD较高(487±143对322±93毫升,p<0.05;7.1±0.7对6.1±0.5厘米,p<0.01)。观察期间HV、EDV和RBV的增加高于其余患者(166±137对39±95毫升,p<0.05;133±75对44±29毫升,p<0.01;66±22对22±31毫升,p<0.01)。平均而言,初始左心室轻度扩张的病例变化不如明显扩张的病例显著。(摘要截选至250词)

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