Picca M, Bisceglia J, Zocca A, Pelosi G
Divisione di Medicina Interna e Servizio di Cardiologia P.O.M.M., Milano.
G Ital Cardiol. 1994 Nov;24(11):1387-94.
The purpose of this study was to assess, using Doppler-echocardiography and ambulatory electrocardiography in patients with mitral valve prolapse (MPV), the prevalence and severity of mitral regurgitation (MR) and arrhythmias.
Two groups of patients were compared: those with thickening and redundancy of the mitral valve leaflets, chordae lengthening and dilatation of the valvular ring (anatomic MVP; n = 40) and those with the only movement anomaly detected by 2D echocardiogram (functional MVP; n = 80).
Significant (moderate or severe) MR was found in 4 (5%) of the 80 patients with functional MVP and in 20 (50%) of the 40 patients with anatomic MVP (p < 0.01). No significant difference in the prevalence of atrial and ventricular arrhythmias was found between patients with functional MPV without MR and 40 randomly chosen control subjects. Arrhythmias in patients with functional MVP complicated by MR were significantly more prevalent (p < 0.05) than in patients with functional MVP without MR. Patients with anatomic MVP had significantly more frequent and more complex arrhythmias than did patients with functional MVP complicated by MR (p < 0.05). There was no significant difference in the prevalence of frequent and complex ventricular arrhythmias between patients with anatomic MVP and patients with functional MVP complicated by MR of comparable hemodynamic degree.
These results indicate that prevalence of significant (moderate or severe) MR is higher and that frequent and complex arrhythmias are significantly more prevalent in patients with anatomic MVP. The prevalence of frequent and complex arrhythmias is similar in patients with comparable MR, whether the regurgitation is related to anatomic MVP or to functional MVP or not.
本研究旨在采用多普勒超声心动图和动态心电图,评估二尖瓣脱垂(MPV)患者二尖瓣反流(MR)和心律失常的发生率及严重程度。
比较两组患者:二尖瓣叶增厚且冗长、腱索延长及瓣环扩张的患者(解剖性MVP;n = 40)和二维超声心动图仅检测到运动异常的患者(功能性MVP;n = 80)。
80例功能性MVP患者中有4例(5%)发现显著(中度或重度)MR,40例解剖性MVP患者中有20例(50%)发现显著MR(p < 0.01)。在无MR的功能性MPV患者与40例随机选择的对照受试者之间,房性和室性心律失常的发生率无显著差异。合并MR的功能性MVP患者的心律失常发生率显著高于无MR的功能性MVP患者(p < 0.05)。解剖性MVP患者的心律失常比合并MR的功能性MVP患者更频繁、更复杂(p < 0.05)。在解剖性MVP患者与血流动力学程度相当的合并MR的功能性MVP患者之间,频发和复杂室性心律失常的发生率无显著差异。
这些结果表明,解剖性MVP患者中显著(中度或重度)MR的发生率更高,频发和复杂心律失常的发生率也显著更高。在MR程度相当的患者中,无论反流与解剖性MVP还是功能性MVP相关,频发和复杂心律失常的发生率相似。