Dhingra R C, Amat-y-Leon F, Pietras R J, Wyndham C, Deedwania P C, Wu D, Denes P, Rosen K M
Ann Intern Med. 1977 Sep;87(3):275-80. doi: 10.7326/0003-4819-87-3-275.
Electrophysiologic studies were done in 32 patients with aortic stenosis. In 24 patients with intact A-V conduction, A-H intervals ranged from 55 to 145 msec and were prolonged in two. Two had split His bundle potentials. The H-V intervals ranged from 25 to 94 msec and were prolonged in 12. The mean H-V interval was 63 +/- 2.6 msec in 12 patients with calcific aortic stenosis compared with 50 +/- 4.9 msec in 12 without calcification (P less than 0.05). The mean H-V in 10 patients with aortic gradients greater than 40 mm Hg was 62 +/- 5.6 msec compared with 47 +/- 3.1 msec in nine with gradients less than 40 (P less than 0.05). In patients with aortic stenosis and A-V block, the site of the block was distal to the His bundle in three and within the His bundle in five. All eight had calcified valves. Aortic stenosis was commonly associated with latent and manifest conduction disease in the His bundle and the trifascicular conduction system. Conduction disease was more extensive with calcified valves and greater valve obstruction.
对32例主动脉瓣狭窄患者进行了电生理研究。在24例房室传导正常的患者中，A-H间期为55至145毫秒，2例延长。2例有分裂的希氏束电位。H-V间期为25至94毫秒，12例延长。12例钙化性主动脉瓣狭窄患者的平均H-V间期为63±2.6毫秒，而12例无钙化患者的平均H-V间期为50±4.9毫秒（P<0.05）。10例主动脉压力阶差大于40 mmHg的患者平均H-V间期为62±5.6毫秒，而9例压力阶差小于40的患者平均H-V间期为47±3.1毫秒（P<0.05）。在主动脉瓣狭窄合并房室传导阻滞的患者中，3例阻滞部位在希氏束远端，5例在希氏束内。所有8例均有钙化瓣膜。主动脉瓣狭窄常与希氏束和三分支传导系统的潜在和明显传导疾病相关。钙化瓣膜和更严重的瓣膜梗阻时传导疾病更广泛。
