Delaye J, Beaune J, Gayet J L, Fatayri W, Silvestre A
Arch Mal Coeur Vaiss. 1983 Sep;76(9):1072-6.
Between 1976 and 1981, 173 patients with severe symptomatic mitral incompetence were referred for preoperative assessment. The etiological diagnosis was based on echocardiography, catheterisation, angiography, and, in the 71 patients operated on, the surgical findings. Rheumatic valvular disease was demonstrated in 40 cases (23,1 p. 100), bacterial endocarditis in II cases (6,3 p. 100), myocardial disease in 30 cases (17,3 p. 100) including 19 cases of mitral incompetence during cardiomyopathy with dilatation, and II cases of mitral incompetence during hypertrophic obstructive cardiomyopathy: ischemic heart disease was the underlying cause in 27 patients (15,6 p. 100), congenital heart disease in 9 patients (5,3 p. 100); dystrophic valvular disease (mitral valve prolapse with or without chordal rupture) was detected in 56 cases (32,3 p. 100). These results show a continuing reduction in the incidence of rheumatic fever and an increase in the number of cases of dystrophic mitral valve disease in patients of 50 to 70 years of age, a condition often rapidly progressive with hemodynamic characteristics very similar to those of mitral incompetence observed in ischemic heart diseases.
1976年至1981年间，173例有严重症状性二尖瓣关闭不全的患者被转诊进行术前评估。病因诊断基于超声心动图、心导管检查、血管造影，对于71例接受手术的患者，还基于手术所见。40例（占23.1%）显示为风湿性瓣膜病，11例（占6.3%）为细菌性心内膜炎，30例（占17.3%）为心肌病，其中19例为扩张型心肌病时出现的二尖瓣关闭不全，11例为肥厚型梗阻性心肌病时出现的二尖瓣关闭不全；27例（占15.6%）的潜在病因是缺血性心脏病，9例（占5.3%）是先天性心脏病；56例（占32.3%）检测出营养不良性瓣膜病（二尖瓣脱垂伴或不伴腱索断裂）。这些结果表明，50至70岁患者中，风湿热的发病率持续下降，而营养不良性二尖瓣疾病的病例数增加，这种疾病通常进展迅速，血流动力学特征与缺血性心脏病中观察到的二尖瓣关闭不全非常相似。
