Vuković I, Smalcelj A, Buljević B, Petrac D, Mirić D
Odjel za unutarnje bolesti-Krizine, KB "Split", Split.
Lijec Vjesn. 1995 Jul-Aug;117(7-8):159-64.
Non-invasive diagnostic methods (history, ECG, phonocardiography, exercise testing, Holter monitoring and Doppler echocardiography) were done in 48 persons with mitral valve prolapse (MVP). The aim was to establish possible risk factors for occurrence of ventricular tachycardia (VT) in persons with MVP and to find a possible difference between these risk factors. The possible risk factors for VT are: syncope, negative T wave in the inferolateral ECG leads, longer duration of QT interval, ST devalvation and duration of the ST devalvation, reduction of oxygen consumption evaluated by exercise testing, left ventricular function impairment, polymorphic premature ventricular contractions (PVC's), paired PVC's, larger dimensions of left cardiac chambers, larger surface and thickness of anterior mitral leaflet, extent of mitral regurgitation and higher mitral valve prolapse score. In patients with sustained VT we found higher age, more frequent syncopal attacks, longer QTc interval, more frequent negative T wave in inferolateral ECG leads, deeper ST devalvations, lower oxygen consumption, more prominent left ventricular function impairment, more frequent polimorphic PVC's (more than 10/1000 ventricular complexes), paired PVC's and thicker anterior mitral leaflet than in patients with non-sustained VT. (For all these risk factors is p < 0.01). Non-invasive diagnostic methods could help to identify the patients with mitral valve prolapse at elevated risk for VT.
对48例二尖瓣脱垂(MVP)患者进行了非侵入性诊断方法(病史、心电图、心音图、运动试验、动态心电图监测和多普勒超声心动图)检查。目的是确定MVP患者发生室性心动过速(VT)的可能危险因素,并找出这些危险因素之间的可能差异。VT的可能危险因素有:晕厥、心电图下壁导联T波倒置、QT间期延长、ST段压低及ST段压低持续时间、运动试验评估的耗氧量降低、左心室功能损害、多形性室性早搏(PVC)、成对PVC、左心腔尺寸增大、二尖瓣前叶表面和厚度增大、二尖瓣反流程度及较高的二尖瓣脱垂评分。在持续性VT患者中,我们发现其年龄更大、晕厥发作更频繁、QTc间期更长、心电图下壁导联T波倒置更频繁、ST段压低更深、耗氧量更低、左心室功能损害更明显、多形性PVC更频繁(超过10/1000个心室复合波)、成对PVC以及二尖瓣前叶更厚,与非持续性VT患者相比。(所有这些危险因素的p值均<0.01)。非侵入性诊断方法有助于识别MVP患者中VT风险升高的患者。