Nitenberg A, Cepisul A, Magnier S, Geschwind H, Ignace C
Arch Mal Coeur Vaiss. 1978 Mar;71(3):348-56.
Disordered left ventricular function and changes in the sub-valvular apparatus appear to be associated in patients with isolated mitral stenosis (MS). Left ventricular cine-angiography has demonstrated two groups of patients, according to the presence (group II) or absence (group I) of changes in the sub-valvular apparatus. There was no significant difference between the two groups in terms of age, heart rate, left ventricular end diastolic pressure, surface area of the mitral valve, or ventricular ejection time. However, group II patients had a lowered ejection fraction (EF), systolic ejection volume (SEB), speed of shortening of circular fibres (VCF), and systolic work index (SWI) compared with group I cases (respectively 0.49 +/- 0.06 and 0.58 +/- 0.04 for the EF, 36 +/- 7 ml.m-2 and 41 +/- 7 ml.m-2 for the SEV, 0.85 +/- 0.12 circ.s-1 and 1.09 +/- 0.16 circ.s-1 for the VCF, 45 +/- 11 gm.m-2 and 57 +/- 11 gm.m-2 for the SWI. Nevertheless, it appears that changes in the sub-valvular apparatus indicate rather than cause dysfunction of the left ventricle, which occurs in a certain number of patients who have a normal sub-valvular apparatus.
在单纯二尖瓣狭窄（MS）患者中，左心室功能紊乱与瓣下结构改变似乎相关。左心室电影血管造影显示，根据瓣下结构有无改变，患者分为两组（II组有改变，I组无改变）。两组在年龄、心率、左心室舒张末期压力、二尖瓣表面积或心室射血时间方面无显著差异。然而，与I组患者相比，II组患者的射血分数（EF）、收缩期射血量（SEB）、环形纤维缩短速度（VCF）和收缩期作功指数（SWI）降低（EF分别为0.49±0.06和0.58±0.04，SEV分别为36±7ml.m-2和41±7ml.m-2，VCF分别为0.85±0.12circ.s-1和1.09±0.16circ.s-1，SWI分别为45±11gm.m-2和57±11gm.m-2）。然而，似乎瓣下结构改变表明而非导致左心室功能障碍，这种功能障碍发生在一定数量瓣下结构正常的患者中。
