Zuppiroli A, Favilli S, Mori F, Dolara A
Cardiologia San Luca, Osp. Careggi, USL 10/D Firenze.
G Ital Cardiol. 1994 Jan;24(1):35-9.
The term mitral valve prolapse is used to describe either one of the pathophysiological mechanisms of mitral regurgitation or a distinct biological condition with a defined inherited basis, with or without mitral incompetence. In the former case, association with rheumatic fever is implied by the definition itself; in the latter it's questionable (rheumatic fever could act as an environmental factor in the expression of a genetically determined mitral valve prolapse). Three hundred and twenty patients with mitral valve prolapse, diagnosed as a primary one, were studied in order to assess the prevalence of a well-documented history of rheumatic fever: this resulted higher versus a control population (5.6% vs 0.9%-p < 0.01). The retrospective nature of the study does not allow a definite conclusion. Familial as well as long-term follow-up studies are necessary to better define the association between rheumatic fever and mitral valve prolapse; a potentially different prognosis, mainly accounting to the development of a clinically relevant mitral regurgitation in patients with mitral valve prolapse and previous rheumatic fever, has to be searched.
二尖瓣脱垂这一术语用于描述二尖瓣反流的病理生理机制之一，或一种具有明确遗传基础的独特生物学状况，伴有或不伴有二尖瓣关闭不全。在前一种情况下，定义本身就暗示了与风湿热有关；在后一种情况下则存在疑问（风湿热可能作为一个环境因素影响遗传决定的二尖瓣脱垂的表现）。为了评估有充分记录的风湿热病史的患病率，对320例被诊断为原发性二尖瓣脱垂的患者进行了研究：结果显示，与对照组相比，患病率更高（5.6%对0.9%，p<0.01）。该研究的回顾性性质不允许得出明确结论。需要进行家族性以及长期随访研究，以更好地界定风湿热与二尖瓣脱垂之间的关联；必须探究一种潜在的不同预后情况，主要是由于二尖瓣脱垂且既往有风湿热的患者发生临床相关二尖瓣反流。
