Gaffney F A, Karlsson E S, Campbell W, Schutte J E, Nixon J V, Willerson J T, Blomqvist C G
Circulation. 1979 May;59(5):894-901. doi: 10.1161/01.cir.59.5.894.
Autonomic cardiovascular regulation was evaluated in 35 women, 19 with mitral valve prolapse and 16 healthy controls. Heart rate responses to the diving reflex and to phenylephrine infusion were diminished in patients. Noninvasive measures of cardiac output, heart rate, blood pressure, forearm flow and leg volume during lower body negative pressure (LBNP) showed that patients had less lower extremity pooling of blood and had lower forearm conductance. Blood pressures during LBNP rose or remained unchanged despite decreases in cardiac output of 20--25%. These data indicate that mitral valve prolapse patients have an increased venous and arterial vasoconstrictor activity. Cardiac output at rest and echocardiographic indices of contractility were normal. Patients with a history of significant ventricular arrhythmias had higher heart rates and lower forward stroke volumes than the other patients or controls. The combined data demonstrate autonomic dysfunction in women with the mitral valve prolapse syndrome and suggest decreased parasympathetic, increased alpha- and normal beta-adrenergic tone and responsiveness.
对35名女性进行了自主心血管调节评估，其中19名患有二尖瓣脱垂，16名作为健康对照。患者对潜水反射和去氧肾上腺素输注的心率反应减弱。在下半身负压（LBNP）期间，对心输出量、心率、血压、前臂血流和腿部容积的非侵入性测量显示，患者下肢血液淤积较少，前臂传导性较低。尽管心输出量下降了20%至25%，LBNP期间的血压仍升高或保持不变。这些数据表明，二尖瓣脱垂患者的静脉和动脉血管收缩活性增加。静息心输出量和收缩性的超声心动图指标正常。有明显室性心律失常病史的患者比其他患者或对照组的心率更高，前向搏出量更低。综合数据表明二尖瓣脱垂综合征女性存在自主神经功能障碍，并提示副交感神经功能降低、α-肾上腺素能张力和反应性增加以及β-肾上腺素能张力和反应性正常。
