Alpert J S, Vieweg W V, Hagan A D
Am Heart J. 1976 Oct;92(4):435-40. doi: 10.1016/s0002-8703(76)80042-7.
The incidence and morphology of shudders in carotid arterial pulse tracings were examined in 73 patients with aortic valve disease documented by cardiac catheterization. Two forms of carotid shudder were recorded: coarse and fine. Shudders were present in 67 per cent of patients with aortic stenosis, 48 per cent of patients with aortic insufficiency, and 57 per cent of patients with mixed aortic stenosis and insufficiency. No significant difference existed among these three groups of patients with respect to the over-all incidence of carotid shudders or with respect to the incidence of coarse or fine shudders. In patients with aortic insufficiency, stroke volume index (Fick) and phonocardiographic systolic ejection murmur amplitude were significantly greater (p less than 0.01, p less than 0.001, respectively) in those with coarse carotid shudders compared with those manifesting fine or absent shudders. Loud, flow-related, systolic ejection murmurs of aortic insufficiency are capable of producing radial vibrations in the aortic wall which are recorded as carotid shudders. The finding of a carotid shudder in a patient with aortic valve disease does not enable the physician to distinguish between stenosis, insufficiency, or mixed stenosis and insufficiency.
对73例经心导管检查证实患有主动脉瓣疾病的患者的颈动脉脉搏描记图中的震颤发生率和形态进行了检查。记录到两种形式的颈动脉震颤：粗大的和细微的。主动脉瓣狭窄患者中67%出现震颤，主动脉瓣关闭不全患者中48%出现震颤，主动脉瓣狭窄合并关闭不全患者中57%出现震颤。这三组患者在颈动脉震颤的总体发生率以及粗大或细微震颤的发生率方面均无显著差异。在主动脉瓣关闭不全患者中，与表现为细微震颤或无震颤的患者相比，出现粗大颈动脉震颤的患者每搏量指数（Fick法）和心音图收缩期喷射性杂音幅度显著更大（分别为p<0.01，p<0.001）。响亮的、与血流相关的主动脉瓣关闭不全收缩期喷射性杂音能够在主动脉壁产生径向振动，这些振动被记录为颈动脉震颤。在患有主动脉瓣疾病的患者中发现颈动脉震颤并不能使医生区分是狭窄、关闭不全还是狭窄合并关闭不全。
