Cohen M, Pocock W A, Lakier J B, McLaren M J, Lachman A S, Barlow J B
Am Heart J. 1978 Jun;95(6):697-701. doi: 10.1016/0002-8703(78)90498-2.
In 1972 we conducted a survey of 12,050 urban Black schoolchildren and detected 168 (prevalence rate of 14 per 1,000) with a non-ejection systolic click (NESC), a late systolic murmur, or both. The etiology of the mitral valve abnormality was unknown but we considered that a significant proportion might have early rheumatic heart disease. The auscultatory features four years later of 139 of the original 168 subjects as well as those of 139 age- and sex-matched controls are presented in this study. No cardiac abnormality was detected in as many as 55 of the subjects. Five children now had pansystolic murmurs but the mitral regurgitation was assessed as mild in four. Twenty-five (17.9 per cent) of the controls, 23 of whom had NESCs, had auscultatory features compatible with mitral valve prolapse. These findings do not support our earlier suggestion that a large number of the 1972 subjects have mild rheumatic heart disease. The results are in accord with other studies which have indicated that auscultatory features compatible with mitral valve prolapse are common in "normals" and also that the prognosis of the specific "billowing mitral leaflet syndrome" is generally benign.
1972年，我们对12050名城市黑人学童进行了调查，发现168名（患病率为每1000人中有14人）有非喷射性收缩期喀喇音（NESC）、收缩晚期杂音或两者皆有。二尖瓣异常的病因不明，但我们认为相当一部分人可能患有早期风湿性心脏病。本研究呈现了最初168名受试者中139名四年后的听诊特征以及139名年龄和性别匹配的对照者的听诊特征。多达55名受试者未检测到心脏异常。现在有5名儿童出现全收缩期杂音，但其中4名的二尖瓣反流被评估为轻度。25名（17.9%）对照者有与二尖瓣脱垂相符的听诊特征，其中23名有非喷射性收缩期喀喇音。这些发现不支持我们之前的观点，即1972年的大量受试者患有轻度风湿性心脏病。这些结果与其他研究一致，这些研究表明与二尖瓣脱垂相符的听诊特征在“正常人”中很常见，并且特定的“二尖瓣叶膨出综合征”的预后通常是良性的。
