Boudoulas H, Reynolds J C, Mazzaferri E, Wooley C F
Circulation. 1980 Jun;61(6):1200-5. doi: 10.1161/01.cir.61.6.1200.
Symptomatic patients with mitral valve prolapse (MVP) frequently mimic thyrotoxicosis, hyperadrenergic states or hypoglycemia. Twenty symptomatic patients with auscultatory and echocardiographic MVP were studied in the clinical research unit. T3, T4 and plasma cortisol were normal. Patients with MVP had normal responses to oral glucose administration but higher glucose levels than the controls (p less than 0.05). Twenty-four-hour urinary epinephrine (E) and norepinephrine (NE) were greater than normal (E + NE excretion, 44 +/- 2 vs 29.5 microgram/g creatinine, p less than 0.001). The short electromechanical systole corrected for heart rate (529 +/- 3.9 vs normal 548 +/- 2 msec, p less than 0.01) also reflected high adrenergic tone. Frequent premature ventricular complexes (PVCs) with couplets and triplets were found in 14 patients. Catecholamine excretion and frequency of PVCs were parallel and both decreased significantly at night (p less than 0.001). Plasma catecholamine increase with exercise was greater in patients in whom the number of PVCs increased more than 10 per minute compared with patients in whom the number of PVCs remained relatively unchanged (620 +/- 80 vs 98 +/- 20 msec, p less than 0.01). We conclude that symptomatic patients with MVP have high adrenergic tone that may be responsible for or contribute to the multiple symptoms.
有症状的二尖瓣脱垂（MVP）患者常常类似甲状腺毒症、高肾上腺素能状态或低血糖。在临床研究室对20例有听诊和超声心动图证据的MVP有症状患者进行了研究。三碘甲状腺原氨酸（T3）、甲状腺素（T4）和血浆皮质醇均正常。MVP患者口服葡萄糖后反应正常，但血糖水平高于对照组（p<0.05）。24小时尿肾上腺素（E）和去甲肾上腺素（NE）高于正常（E+NE排泄量，44±2对29.5微克/克肌酐，p<0.001）。校正心率后的短机电收缩期（529±3.9对正常548±2毫秒，p<0.01）也反映了高肾上腺素能状态。14例患者发现频发室性早搏（PVC）伴成对和三联律。儿茶酚胺排泄量和PVC频率呈平行关系，且夜间均显著降低（p<0.001）。与PVC数量相对不变的患者相比，运动时血浆儿茶酚胺升高幅度更大，PVC数量每分钟增加超过10次的患者（620±80对98±20毫秒，p<0.01）。我们得出结论，有症状的MVP患者具有高肾上腺素能状态，这可能是多种症状的原因或促成因素。
