Udoshi M B, Shah A, Fisher V J, Dolgin M
Am Heart J. 1979 Mar;97(3):303-11. doi: 10.1016/0002-8703(79)90429-0.
The incidence of mitral valve prolapse (MVP) in 80 patients with various thoracic skeletal abnormalities (TSA) was examined prospectively using compete history and physical examination, chest x-rays, electrocardiography, phonocardiography, and echocardiography. There were 76 males and four females, ranging in age from 18 to 80 years. Thirty-four patients had narrow anteroposterior diameter of the chest (asthenic habitus) (Group 1), 13 had straight back (Group 2), and 33 had pectus excavatum (Group 3). Twenty-five of the 80 patients (31 per cent) had evidence of MVP, 22 by echocardiographic criteria and three by phonocardiographic criteria. The incidence of MVP in this predominantly male population was substantially higher than that reported in the general adult population. Thoracic skeletal abnormality is an important nonauscultatory feature of mitral valve prolapse syndrome. The association between TSA and MVP may be a manifestation of a single connective tissue defect during embryonic development of the bony thoracic cage and the atrioventricular valves. All patients with TSA, even when asymptomatic, should be screened for MVP by noninvasive investigations. The recognition of MVP in patients with TSA may be of potential value in prevention of life-threatening endocarditis and cardiac arrhythmia.
采用完整病史、体格检查、胸部X光、心电图、心音图及超声心动图等方法，对80例患有各种胸廓骨骼异常（TSA）的患者进行前瞻性研究，以检查二尖瓣脱垂（MVP）的发生率。患者中有76例男性和4例女性，年龄在18至80岁之间。34例患者胸廓前后径狭窄（无力体型）（第1组），13例有直背（第2组），33例有漏斗胸（第3组）。80例患者中有25例（31%）有二尖瓣脱垂的证据，其中22例符合超声心动图标准，3例符合心音图标准。在这个以男性为主的人群中，二尖瓣脱垂的发生率显著高于一般成年人群中报告的发生率。胸廓骨骼异常是二尖瓣脱垂综合征一个重要的非听诊特征。胸廓骨骼异常与二尖瓣脱垂之间的关联可能是在胸廓骨骼和房室瓣胚胎发育过程中单一结缔组织缺陷的一种表现。所有胸廓骨骼异常患者，即使无症状，也应通过无创检查筛查二尖瓣脱垂。在胸廓骨骼异常患者中识别二尖瓣脱垂对于预防危及生命的心内膜炎和心律失常可能具有潜在价值。
