Herbert W H
Thorax. 1970 Sep;25(5):577-80. doi: 10.1136/thx.25.5.577.
The haemodynamic and electrocardiographic data of 10 patients with aortic insufficiency were reviewed. None of them had received a digitalis preparation, and all had a significantly longer P-R interval than 10 similarly studied normal patients (mean P-R 0·213 and 0·153 second respectively, p<0·001) thus corroborating previous reports of the association of atrio-ventricular conduction delay and aortic insufficiency. Left ventricular end-diastolic pressure was approximately the same or higher than pulmonary artery systolic pressure in three patients and higher than pulmonary artery end-diastolic pressure in seven patients. An analysis of the timing of atrio-ventricular events suggested that an earlier atrial systole (due to P-R prolongation) enabled an increment of forward flow which would otherwise be precluded by the premature closure of the mitral valve associated with aortic insufficiency. Due to the advantageous timing, left atrial and therefore right heart pressures were lower, thus tending to protect the pulmonary vascular bed.
回顾了10例主动脉瓣关闭不全患者的血流动力学和心电图数据。他们均未接受过洋地黄制剂治疗，且与10例经类似研究的正常患者相比，所有患者的P-R间期均显著延长（分别为平均P-R 0.213秒和0.153秒，p<0.001），从而证实了先前关于房室传导延迟与主动脉瓣关闭不全相关性的报道。3例患者的左心室舒张末期压力约与肺动脉收缩压相同或更高，7例患者的左心室舒张末期压力高于肺动脉舒张末期压力。对房室事件发生时间的分析表明，较早的心房收缩（由于P-R延长）使得前向血流增加，否则会因与主动脉瓣关闭不全相关的二尖瓣过早关闭而受到阻碍。由于有利的时间安排，左心房以及右心压力较低，从而倾向于保护肺血管床。
