Osbakken M D, Bove A A, Spann J F
Am J Cardiol. 1981 May;47(5):1005-9. doi: 10.1016/0002-9149(81)90205-8.
Left ventricular regional wall motion (percent systolic shortening) and velocity of shortening were studied in patients with heart failure due to chronic volume overloads of mitral and aortic regurgitation. Biplane left ventriculograms were analyzed by computer and divided into four regions: anterior, inferior, posterolateral and septal. The study patients included 12 normal subjects; 21 patients with aortic regurgitation (10 asymptomatic and 11 with congestive heart failure); and 11 patients with mitral regurgitation (4 asymptomatic and 7 with congestive heart failure). No patient had coronary artery disease. With heart failure, ejection fraction was decreased (p less than 0.05) in both aortic and mitral regurgitation (normal 62 +/- 3 percent [mean +/- standard error of the mean], aortic regurgitation 48 +/- 3 and mitral regurgitation 51 +/- 5). In mitral regurgitation with heart failure, the percent segment shortening in anterior (normal 42 +/- 2, mitral regurgitation 27 +/- 5) and posterolateral (normal 23 +/- 3, mitral regurgitation 16 +/- 4) regions was significantly decreased (p less than 0.05), whereas this value in the inferior (normal 32 +/- 2, mitral regurgitation 28 +/- 6) and septal (normal 46 +/- 4, mitral regurgitation 47 +/- 5) regions was normal. In aortic regurgitation with heart failure, anterior (27 +/- 2), inferior (17 +/- 3) and septal (5 +/- 1) segment shortening was significantly decreased, whereas posterolateral segment shortening was significantly decreased, whereas posterolateral segment shortening was normal (24 +/- 3). In both groups with heart failure, mean shortening velocity showed regional variations similar to those of percent shortening, whereas peak instantaneous shortening velocity was not reduced in mitral regurgitation compared with normal values. In the asymptomatic group, shortening and mean shortening velocity were normal, whereas peak instantaneous shortening velocity was increased in mitral regurgitation. In aortic and mitral regurgitation with decreased left ventricular function demonstrated by a reduced ejection fraction, there are regional wall motion abnormalities that are not caused by coronary disease.
对因二尖瓣和主动脉瓣反流导致慢性容量负荷过重而心力衰竭的患者进行了左心室局部壁运动（收缩期缩短百分比）和缩短速度的研究。通过计算机分析双平面左心室造影，并将其分为四个区域：前壁、下壁、后外侧壁和室间隔。研究对象包括12名正常受试者；21例主动脉瓣反流患者（10例无症状，11例伴有充血性心力衰竭）；以及11例二尖瓣反流患者（4例无症状，7例伴有充血性心力衰竭）。所有患者均无冠状动脉疾病。心力衰竭时，主动脉瓣反流和二尖瓣反流患者的射血分数均降低（p<0.05）（正常为62±3%[平均值±平均值的标准误差]，主动脉瓣反流为48±3，二尖瓣反流为51±5）。在伴有心力衰竭的二尖瓣反流患者中，前壁（正常为42±2，二尖瓣反流为27±5）和后外侧壁（正常为23±3，二尖瓣反流为16±4）区域的节段缩短百分比显著降低（p<0.05），而下壁（正常为32±2，二尖瓣反流为28±6）和室间隔（正常为46±4，二尖瓣反流为47±5）区域的值正常。在伴有心力衰竭的主动脉瓣反流患者中，前壁（27±2）、下壁（17±3）和室间隔（5±1）节段缩短显著降低，而后外侧壁节段缩短正常（24±3）。在两组心力衰竭患者中，平均缩短速度显示出与缩短百分比相似的区域差异，而二尖瓣反流患者的峰值瞬时缩短速度与正常值相比并未降低。在无症状组中，缩短和平均缩短速度正常，而二尖瓣反流患者的峰值瞬时缩短速度增加。在射血分数降低表明左心室功能下降的主动脉瓣反流和二尖瓣反流患者中，存在并非由冠状动脉疾病引起的局部壁运动异常。
