Bernstein N E, Demopoulos L A, Tunick P A, Rosenzweig B P, Kronzon I
Charles and Rose Wohlstetter Noninvasive Cardiology Laboratory, Department of Medicine, New York University Medical Center, NY 10016.
Am Heart J. 1994 Aug;128(2):287-92. doi: 10.1016/0002-8703(94)90481-2.
The purpose of this study was to evaluate the correlates of spontaneous echo contrast in mitral stenosis and normal sinus rhythm. Spontaneous echo contrast is associated with clot formation and embolic phenomena. It has been noted in conditions involving blood stasis, especially mitral stenosis and atrial fibrillation, but the correlates of spontaneous echo contrast in patients with mitral stenosis and normal sinus rhythm have not been extensively evaluated. The transthoracic and transesophageal echocardiograms and clinical findings of 47 patients with mitral stenosis and normal sinus rhythm were reviewed. Left atrial size, mean transmitral gradient, and valve area were measured, and the presence or absence of spontaneous echo contrast in the left atrium was noted. Spontaneous echo contrast was found in the echocardiograms of 21 (45%, group 1) of 47 patients. There was no contrast in those of the other 26 patients (group 2). Mean transmitral gradient was significantly higher in group 1 (13.6 +/- 5.2 mm Hg) than in group 2 (10.5 +/- 4.9 mm Hg) (p < 0.05). Mitral valve area was significantly smaller in group 1 than in group 2 (1.0 +/- 0.5 vs 1.4 +/- 0.5 cm2; p < 0.02). There was a trend toward a higher prevalence of significant mitral regurgitation in group 2. There was no significant difference with respect to age, left atrial size, history of embolism, or warfarin therapy. We conclude that spontaneous echo contrast in the left atrium of patients with mitral stenosis and normal sinus rhythm is common and is associated with a significantly smaller mitral valve area and higher mitral gradient.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估二尖瓣狭窄且窦性心律正常时自发显影的相关因素。自发显影与血栓形成及栓塞现象相关。在涉及血液淤滞的情况下已观察到该现象，尤其是二尖瓣狭窄和心房颤动，但二尖瓣狭窄且窦性心律正常患者的自发显影相关因素尚未得到广泛评估。回顾了47例二尖瓣狭窄且窦性心律正常患者的经胸和经食管超声心动图及临床 findings。测量左心房大小、平均二尖瓣跨瓣压差和瓣膜面积，并记录左心房内有无自发显影。47例患者中，21例（45%，第1组）的超声心动图发现有自发显影。其他26例患者（第2组）未发现显影。第1组的平均二尖瓣跨瓣压差（13.6±5.2 mmHg）显著高于第2组（10.5±4.9 mmHg）（p<0.05）。第1组的二尖瓣瓣膜面积显著小于第2组（1.0±0.5 vs 1.4±0.5 cm2；p<0.02）。第2组中重度二尖瓣反流的患病率有升高趋势。在年龄、左心房大小、栓塞病史或华法林治疗方面无显著差异。我们得出结论，二尖瓣狭窄且窦性心律正常患者左心房内的自发显影很常见，且与二尖瓣瓣膜面积显著减小和二尖瓣压差升高相关。（摘要截断于250字） （注：原文中“findings”未翻译完整，可能是有遗漏信息。）
