Kebukawa K, Magosaki N, Sakai K, Umemura J, Ueda T, Kimura H, Hidai C, Suzuki T, Kasanuki H, Hosoda S
Department of Cardiology, Tokyo Women's Medical College.
Kokyu To Junkan. 1993 Dec;41(12):1165-71.
The aim of this report is to investigate the factors which influence mean left atrial pressure (LAP) after percutaneous transvenous mitral commissurotomy (PTMC) and the characteristics of patients in whom PTMC is most effective. Fifty one patients with symptomatic mitral stenosis underwent PTMC. The patients included 8 males and 43 females, aged 26-66 years (mean age of 46). These patients were classified into two groups according to LAP after PTMC: 31 cases with LAP after PTMC of 12 mmHg or less (group A) and 20 cases with LAP after PTMC greater than 12 mmHg (group B). The patients of group A were younger (44 +/- 6 vs 48 +/- 6 years, p < 0.05), and had atrial fibrillation (af) less frequently (35 vs 65%, p < 0.05), and had mitral valve calcification less frequently (29 vs 65%, p < 0.01). Before PTMC, LAP (19 +/- 6 vs 23 +/- 5 mmHg, p < 0.01) was lower and mitral valve area (MVA) (0.95 +/- 0.24 vs 0.81 +/- 0.15 cm2, p < 0.05) larger in group A. Symptoms graded according to the New York Heart Association functional classification system were similar in both groups before PTMC. After the procedure, final MVA (1.79 +/- 0.69 vs 1.40 +/- 0.50 cm2, p < 0.05) was larger and systolic pulmonary artery pressure (32 +/- 9 vs 39 +/- 7 mmHg, p < 0.01) lower in group A. Mitral regurgitation > or = 3-grade tended to complicate more frequently (3 vs 20%, NS) in group B.(ABSTRACT TRUNCATED AT 250 WORDS)
本报告旨在研究经皮经静脉二尖瓣交界切开术（PTMC）后影响平均左心房压（LAP）的因素以及PTMC最有效的患者特征。51例有症状的二尖瓣狭窄患者接受了PTMC。患者包括8名男性和43名女性，年龄26 - 66岁（平均年龄46岁）。这些患者根据PTMC后的LAP分为两组：PTMC后LAP为12 mmHg或更低的31例（A组）和PTMC后LAP大于12 mmHg的20例（B组）。A组患者更年轻（44±6岁对48±6岁，p<0.05），房颤（af）发生率更低（35%对65%，p<0.05），二尖瓣钙化发生率更低（29%对65%，p<0.01）。PTMC前，A组的LAP更低（19±6 mmHg对23±5 mmHg，p<0.01），二尖瓣面积（MVA）更大（0.95±0.24 cm²对0.81±0.15 cm²，p<0.05）。根据纽约心脏协会功能分类系统分级的症状在PTMC前两组相似。术后，A组的最终MVA更大（1.79±0.69 cm²对1.40±0.50 cm²，p<0.05），收缩期肺动脉压更低（32±9 mmHg对39±7 mmHg，p<0.01）。B组二尖瓣反流≥3级的并发症发生率更高（3%对20%，无统计学差异）。 （摘要截断于250字）
