Mlczoch J, Kummer F, Ferlitsch A, Haber P, Dorda W
Acta Med Austriaca. 1980;7(4-5):107-10.
Pulmonary function patterns were found to be different in patients with "pure" mitral stenosis (= 29), with concomitant mitral incompetence (n = 18) and with coronary heart disease (n = 12). Lung function in "pure" mitral stenosis has a trend to increased airway resistance with low vital capacity, without any statistical correlation between lung function data and hemodynamics. Coronary heart disease, in contrast, was found to show lung function abnormalities indicating increased pulmonary capillary volume and passive pulmonary hypertension, both being compatible with latent congestive failure. The group with combined mitral valve disease represented an intermediate type of cardiac lung. It can be concluded that a reflex mechanism is important in mitral stenosis between interstitial lung tissue and bronchomotor tone, but not necessarily between left atrium and pulmonary arteriolar tone. This reflex apparently is weaker in combined mitral valve disease and practically absent in coronary heart disease, where the expected lung function pattern compatible with early congestion should be encountered. The different pattern of mitral stenosis seems however, not to be related to the valve stenosis, but to the longstanding increase in pressures. The same mechanisms have been demonstrated in patients with acute left heart failure.
研究发现，“单纯”二尖瓣狭窄患者（n = 29）、合并二尖瓣关闭不全患者（n = 18）和冠心病患者（n = 12）的肺功能模式有所不同。“单纯”二尖瓣狭窄患者的肺功能呈现出气道阻力增加且肺活量降低的趋势，肺功能数据与血流动力学之间无任何统计学相关性。相比之下，冠心病患者的肺功能异常表现为肺毛细血管容量增加和被动性肺动脉高压，这两者均与潜在的充血性心力衰竭相符。合并二尖瓣疾病的患者组代表了一种中间类型的心肺情况。可以得出结论，在二尖瓣狭窄中，间质肺组织与支气管运动张力之间的反射机制很重要，但左心房与肺小动脉张力之间不一定如此。这种反射在合并二尖瓣疾病时明显较弱，而在冠心病中实际上不存在，在冠心病中应会出现与早期充血相符的预期肺功能模式。然而，二尖瓣狭窄的不同模式似乎与瓣膜狭窄无关，而是与压力的长期升高有关。急性左心衰竭患者也证实了同样的机制。
