Bolen J L, Alderman E L
Am J Cardiol. 1977 Feb;39(2):177-83. doi: 10.1016/s0002-9149(77)80188-4.
Quantitative angiographic findings were reviewed in 40 patients with significant mitral regurgitation classified into three etiologic groups: group I, primary mitral regurgitation (prolapse, ruptured chordae); group II, mixed stenosis and regurgitation of rheumatic origin; and group III, cardiomyopathic mitral regurgitation. For patients in both groups I and II, left ventricular end-diastolic volume was directly related to regurgitant fraction, and ejection fraction was generally well maintained. In contrast, patients in group III had a depressed ejection fraction (less than 0.40) and end-diastolic volume that was disproportionately increased in relation to the degree of regurgitation. Left ventricular end-diastolic pressure was a poor indicator of severity of regurgitation in all patient groups. There was a significant negative correlation between forward cardiac index and regurgitant fraction. There was significant relation, although with considerable variation, between the normalized V wave and regurgitant fraction. The graphs of chamber size, ejection fraction and hemodynamic measures plotted against the severity of regurgitation in different patient groups provide a perspective for interpreting the findings in individual patients.
对40例有严重二尖瓣反流的患者的定量血管造影结果进行了回顾，这些患者被分为三个病因组：第一组，原发性二尖瓣反流（脱垂、腱索断裂）；第二组，风湿性起源的混合性狭窄和反流；第三组，心肌病性二尖瓣反流。对于第一组和第二组的患者，左心室舒张末期容积与反流分数直接相关，射血分数一般保持良好。相比之下，第三组患者的射血分数降低（小于0.40），舒张末期容积相对于反流程度不成比例地增加。左心室舒张末期压力在所有患者组中都不是反流严重程度的良好指标。心脏前向指数与反流分数之间存在显著的负相关。标准化V波与反流分数之间存在显著关系，尽管存在相当大的差异。不同患者组中腔室大小、射血分数和血流动力学指标与反流严重程度的关系图为解释个体患者的结果提供了一个视角。
