Sahn D J, Allen H D, Goldberg S J, Friedman W F
Circulation. 1976 Apr;53(4):651-7. doi: 10.1161/01.cir.53.4.651.
The cross-sectional echocardiographic features of mitral valve prolapse were defined in 26 children (ages 2-18 years) using a real-time, multiple-crystal ultrasound scanner. In each patient the physical findings of the mitral valve click-murmur syndrome were present and mitral valve prolapse had been diagnosed previously by conventional single crystal echocardiography. Mitral prolapse occurred in a familial setting in eight patients and was associated with the Marfan syndrome in five. Real-time two-dimensional echocardiography uniformly disclosed maximum mitral arching and the superior-posterior prolapse. These visual observations were confirmed by M-mode recordings derived from single elements within the array of 20 crystals. The method allowed a complete M-mode description of the phasic motion of the entire mitral apparatus and observations of the spectrum of prolapse from discrete late systolic prolapse to "hammock-like" holosystolic prolapse. Further, the recording of multiple systolic M-mode lines occurred when the ultrasound beam intersected the arched leaflets more than once. Pseudosystolic anterior motion was observed often and resulted clearly from a superimposition of echoes from the mitral annulus and from the posterior-superiorly arched prolapsed leaflets. A major finding in 22 patients was the association with prolapse of biconvex enlargement of the aortic sinuses of Valsalva and a significant increase in the diameter of the aortic root. Aortic root dilatation was most marked in, but not confined to, patients with the Marfan syndrome and was a prominent finding in six patients with minor musculoskeletal abnormalities. The presence of aortic root dilatation in children with normal body habitus raises important questions concerning the generalized nature of an abnormality of cardiac connective tissue in patients with mitral prolapse. The cross-sectional approach significantly enhances the noninvasive evaluation of mitral valve prolapse and provides an explanation for many of the single crystal observations reported previously.
使用实时多晶体超声扫描仪对26名儿童（年龄2至18岁）二尖瓣脱垂的超声心动图横断面特征进行了界定。每名患者均有二尖瓣喀喇音 - 杂音综合征的体格检查表现，且此前已通过传统单晶超声心动图诊断为二尖瓣脱垂。二尖瓣脱垂在8名患者中呈家族性发病，5名患者与马方综合征相关。实时二维超声心动图一致显示二尖瓣最大弓起及后上脱垂。这些视觉观察结果通过来自20个晶体阵列中的单个元件的M型记录得到证实。该方法能够对整个二尖瓣装置的相位运动进行完整的M型描述，并观察从离散的收缩晚期脱垂到“吊床样”全收缩期脱垂的脱垂频谱。此外，当超声束多次与弓起的瓣叶相交时，会记录到多个收缩期M型线。常观察到假性收缩期前向运动，这显然是二尖瓣环回声与后上弓起的脱垂瓣叶回声叠加所致。22名患者的一个主要发现是，二尖瓣脱垂与主动脉窦双凸扩大以及主动脉根部直径显著增加有关。主动脉根部扩张在马方综合征患者中最为明显，但并不局限于此，在6名有轻微肌肉骨骼异常的患者中也是一个突出发现。体型正常儿童出现主动脉根部扩张，这对于二尖瓣脱垂患者心脏结缔组织异常的普遍性提出了重要问题。横断面检查方法显著增强了二尖瓣脱垂的无创评估，并为先前报道的许多单晶观察结果提供了解释。
