Sabbah H N, Stein P D
Am J Cardiol. 1978 Jan;41(1):32-8. doi: 10.1016/0002-9149(78)90128-5.
The occurrence and magnitude of the incisura of the central aortic pressure were shown in 66 patients to depend on the functional state of the aortic valve. In normal subjects and children with congenital aortic stenosis (with thin flexible leaflets), the incisura ranged between 6 and 14 mm Hg. With aortic regurgitation, the incisura diminished as the severity of regurgitation increased. With calcific aortic stenosis, the incisura was smaller or absent. These observations imply a valve mechanism productive of the incisura. In vitro studies of human aortic valves confirmed these observations. Additional in vitro studies with high speed cinematography (2,000 frames/sec) of a stented normal porcine valve also showed that early diastolic stretch and recoil of the leaflets occurs. These results indicate that in the presence of a normal or diseased aortic valve the aortic incisura is produced primarily by valve distension or recoil, respectively. Distension and rebound of the aortic walls do not appear to contribute significantly in the presence of a normal or a diseased valve. Because acquired aortic valve disease affects the magnitude of the central aortic incisura, inspection of the incisura may be of ancillary valve in evaluating the pathologic state of the aortic valve.
66例患者的中心主动脉压切迹的出现情况及幅度显示取决于主动脉瓣的功能状态。在正常受试者及先天性主动脉狭窄（瓣叶薄且柔韧）的儿童中，切迹范围在6至14毫米汞柱之间。伴有主动脉反流时，随着反流严重程度增加，切迹减小。伴有钙化性主动脉狭窄时，切迹较小或无切迹。这些观察结果提示存在产生切迹的瓣膜机制。对人体主动脉瓣的体外研究证实了这些观察结果。对带有支架的正常猪瓣膜进行的高速电影摄影（每秒2000帧）的额外体外研究也显示，瓣叶在舒张早期会伸展和回弹。这些结果表明，在存在正常或病变主动脉瓣的情况下，主动脉切迹分别主要由瓣膜扩张或回弹产生。在存在正常或病变瓣膜的情况下，主动脉壁的扩张和回弹似乎不起显著作用。由于后天性主动脉瓣疾病会影响中心主动脉切迹的幅度，因此检查切迹可能有助于评估主动脉瓣的病理状态。
