Tomov I
Vutr Boles. 1980;19(1):16-28.
The potentialities of M-type echocardiography (EchoCG) for the evaluation of left ventricle function and the diagnosis of mitral regurgitation are studied in 76 patients with isolated, "pure" mitral insufficiency, confirmed at the clinic and by instrumental non-invasive and invasive examinations (right and left cardiac catherterization and left ventricle angiography). All EchoCG-alterations found have a non-specific character and are a manifestation of volume loading of the left ventricle and left auricle--increased volume and velocity of mitral blood flow. The presence of some of the following functional indices is of highest significance for EchoCG-diagnosis of mitral insufficiency: determination of regurgitation volume, regurgitation fraction and regurgitation index of left ventricle resp., growth of the telemetric size and volume, beat and minute volume of left ventricle, increased indices for the total and local contraction function of left ventricle, increased dimensions of left auricle, slightly elevated velocity and amplitude diastolic indices of anterior cusp of the mitral valve. The high-degree mitral insufficiency often masks EchoCG-manifestation of left ventricle contractility insufficiency. That is the reason why in case of significant mitral insufficiency, the normal or lightly diminished values of contractility indices--fraction of shortening, fraction of expulsion and average velocity of contraction of the circumferential fibres, are a manifestation of reduced contractability of left ventricle. The values of those EchoCG-indices significantly decrease only in mitral insufficiency with severe left ventricle dysfunction. EchoCG enables an approximate evaluation of the degree of mitral insufficiency, differentiating the light and moderate from severe mitral regurgitation with a relative accuracy. The extent of the regurgitation volume, fraction and index, the diastolic size and volume, beat and minute volume of left ventricle and the size of left auricle are of highest importance for the determination of the degree of mitral insufficiency. With light mitral insufficiency, EchoCG could be absolutely normal.
对76例经临床及无创和有创检查（右心和左心导管检查及左心室造影）确诊为单纯“纯”二尖瓣关闭不全的患者，研究了M型超声心动图（EchoCG）评估左心室功能及诊断二尖瓣反流的潜力。所有发现的EchoCG改变均具有非特异性，是左心室和左心房容量负荷增加的表现——二尖瓣血流容积和速度增加。以下一些功能指标的存在对二尖瓣关闭不全的EchoCG诊断具有最高意义：分别测定左心室反流容积、反流分数和反流指数；左心室遥测大小和容积、心搏量和每分输出量增加；左心室整体和局部收缩功能指标增加；左心房尺寸增大；二尖瓣前叶舒张期速度和幅度指标轻度升高。高度二尖瓣关闭不全常掩盖左心室收缩功能不全的EchoCG表现。这就是为什么在严重二尖瓣关闭不全时，收缩功能指标——缩短分数、射血分数和圆周纤维平均收缩速度正常或轻度降低，是左心室收缩性降低的表现。只有在伴有严重左心室功能障碍的二尖瓣关闭不全时，这些EchoCG指标的值才会显著降低。EchoCG能够大致评估二尖瓣关闭不全的程度，以相对准确的程度区分轻度和中度与重度二尖瓣反流。反流容积、分数和指数、左心室舒张期大小和容积、心搏量和每分输出量以及左心房大小对于确定二尖瓣关闭不全的程度最为重要。轻度二尖瓣关闭不全时，EchoCG可能完全正常。
