Sabbah H N, Magilligan D J, Lakier J B, Stein P D
Am J Cardiol. 1982 Jul;50(1):53-8. doi: 10.1016/0002-9149(82)90008-x.
The purpose of this study was to assess the hemodynamic determinant of the amplitude and frequency of a musical murmur produced by a regurgitant degenerated bioprosthetic valve in the mitral position. The prosthetic valve, obtained at surgery, was studied in the mitral position of an in vitro pulse duplicating system. In vitro, the valve produced a musical murmur that was caused by flutter of a flail leaflet. When the peak pressure difference between the left ventricle and left atrium was increased from 95 to 150 mm Hg, the fundamental frequency of the musical murmur increased from 91 to 187 hertz and the amplitude increased from 2,080 to 11,420 dynes/cm2. The fundamental frequency of the musical murmur was linearly related to the peak systolic pressure difference between the left ventricle and the left atrium (correlation coefficient [r] = 0.99). Similarly, the fundamental frequency of the musical murmur was linearly related to the magnitude of regurgitant flow across the valve (r = 0.99); and the regurgitant flow as expected was linearly related to the systolic pressure difference between the left ventricle and left atrium. The amplitude of the musical murmur was also related to both the peak systolic pressure difference between the left ventricle and left atrium (r = 0.99) and the magnitude of regurgitant flow (r = 0.99). These results indicate that the magnitude of regurgitant flow, determined by the systolic pressure difference between the left ventricle and left atrium, was a determinant of both the amplitude and the frequency of the musical murmur.
本研究的目的是评估二尖瓣位反流性退化生物瓣产生的音乐性杂音的幅度和频率的血流动力学决定因素。在体外脉动复制系统的二尖瓣位对手术中获取的人工瓣膜进行研究。在体外，该瓣膜产生了由连枷瓣叶扑动引起的音乐性杂音。当左心室与左心房之间的峰值压差从95 mmHg增加到150 mmHg时，音乐性杂音的基频从91赫兹增加到187赫兹，幅度从2,080达因/平方厘米增加到11,420达因/平方厘米。音乐性杂音的基频与左心室和左心房之间的收缩期峰值压差呈线性相关（相关系数[r]=0.99）。同样，音乐性杂音的基频与跨瓣反流流量的大小呈线性相关（r = 0.99）；并且如预期的那样，反流流量与左心室和左心房之间的收缩压差呈线性相关。音乐性杂音的幅度也与左心室和左心房之间的收缩期峰值压差（r = 0.99）以及反流流量的大小（r = 0.99）相关。这些结果表明，由左心室和左心房之间的收缩压差决定的反流流量大小是音乐性杂音的幅度和频率的决定因素。
