Pasternac A, Tubau J F, Puddu P E, Król R B, de Champlain J
Am J Med. 1982 Dec;73(6):783-90. doi: 10.1016/0002-9343(82)90758-6.
Total plasma catecholamine levels, plasma norepinephrine levels, heart rate, and systolic and diastolic pressures were measured in 15 symptomatic patients with mitral valve prolapse and in 19 normal subjects in supine baseline conditions and in a standing position. In the 15 symptomatic patients, total plasma catecholamine levels and plasma norepinephrine levels were significantly elevated in both positions, and heart rate was lower than in normal subjects in the supine position but returned to normal in the upright position. Thus, symptomatic patients with mitral valve prolapse demonstrate increased resting sympathetic tone. In addition, the associated supine bradycardia suggested that increased vagal tone might also be present at rest. These observations support the hypothesis of a dual autonomic dysfunction in these patients and could account for some of the clinical manifestations of the mitral valve prolapse syndrome.
在仰卧位基线状态和站立位时，对15例有症状的二尖瓣脱垂患者及19名正常受试者测量了血浆儿茶酚胺总量、血浆去甲肾上腺素水平、心率以及收缩压和舒张压。在这15例有症状的患者中，两个体位下血浆儿茶酚胺总量和血浆去甲肾上腺素水平均显著升高，仰卧位时心率低于正常受试者，但直立位时恢复正常。因此，有症状的二尖瓣脱垂患者表现出静息交感神经张力增加。此外，相关的仰卧位心动过缓提示静息时可能也存在迷走神经张力增加。这些观察结果支持了这些患者存在双重自主神经功能障碍的假说，并可解释二尖瓣脱垂综合征的一些临床表现。
