Accorsi F, Velitti F, Serino W, Caizza M S, Palumbo L, Argento G, Coviello R, Armignacco L
G Ital Cardiol. 1984 Aug;14(8):589-93.
Three patients whose aortic incompetence (A.I.) was recognized in childhood, have had an angiographic study 10, 9 and 4 years, respectively, following the first clinical diagnosis of their valvular disease. A.I. was related, in all three cases, to a dysplastic valve ("floppy valve syndrome"); in none of them was there an abnormal dilatation of ascending aorta. In our opinion, the absence of an abnormal aortic root dilatation separates our cases from those in whom aortic regurgitation is part of Marfan's syndrome, either in its full form or in the "forme fruste". From the clinical viewpoint, the presence of a normal ascending aorta could explain the mild course of these cases, as compared to the rapid progression observed in Marfan's syndrome. In the attempt to differentiate the two types of dysplastic valvular disease from an etiologic viewpoint, we suggest that the basic problem in our patients could be an alteration of the valvular connective tissue development, rather than a genetic disorder, like the one possibly responsible for Marfan's syndrome.
三名在儿童期被诊断为主动脉瓣关闭不全(A.I.)的患者,分别在首次临床诊断瓣膜疾病后的10年、9年和4年接受了血管造影研究。在所有三例中,A.I.均与发育异常的瓣膜(“松弛瓣膜综合征”)有关;三例患者的升主动脉均无异常扩张。我们认为,升主动脉无异常扩张使我们的病例有别于那些主动脉反流是马凡综合征全部或“顿挫型”表现一部分的病例。从临床角度看,升主动脉正常可以解释这些病例与马凡综合征中观察到的快速进展相比病程较轻的原因。为了从病因学角度区分这两种发育异常的瓣膜疾病,我们认为我们患者的基本问题可能是瓣膜结缔组织发育的改变,而不是像可能导致马凡综合征的那种遗传疾病。