Mitral valve prolapse in short-term experimental coronary occlusion: a possible mechanism of ischemic mitral regurgitation.
Mitral valve prolapse in short-term experimental coronary occlusion: a possible mechanism of ischemic mitral regurgitation.
复制标题
短期实验性冠状动脉闭塞中的二尖瓣脱垂：缺血性二尖瓣反流的可能机制。
DOI：
10.1161/01.cir.68.1.183
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发表时间：
1983
期刊：
影响因子：
37.8
通讯作者：
Corday,E
中科院分区：
文献类型：
--
作者：
Tei,C;Sakamaki,T;Shah,PM;Meerbaum,S;Kondo,S;Shimoura,K;Corday,E
在12只闭胸犬上进行了实验性冠状动脉闭塞，以研究急性心肌缺血时二尖瓣复合体的功能解剖特征。二维超声心动图用于评估左心室功能，二尖瓣复合体和左心房大小。通过左心室造影超声心动图评估二尖瓣返流的存在。在左前降支和左回旋支冠状动脉的近端或远端位置进行了37次持续时间长达10分钟的冠状动脉闭塞。在37个简短的冠状动脉闭塞实验中，有15个观察到了二尖瓣反流，根据肺动脉楔压的小幅上升来判断，其严重程度为轻度。在所有15项实验中均观察到二尖瓣脱垂，在另外4项研究中未观察到二尖瓣返流。实验性二尖瓣脱垂的发展可以通过测量结果来解释，这些测量结果表明乳头肌尖端向二尖瓣口的相对位移。我们的结论是二尖瓣脱垂是短期冠状动脉闭塞的常见后遗症，通常与轻度二尖瓣返流有关。缺血性乳头肌向二尖瓣口的相对位移似乎是急性缺血性二尖瓣脱垂的可能机制。
Experimental coronary occlusions were carried out in 12 closed-chest dogs to investigate the functional anatomic characteristics of the mitral valve complex during acute myocardial ischemia. Two-dimensional echocardiography was used to assess left ventricular function, the mitral valve complex, and left atrial size. Presence of mitral regurgitation was assessed by left ventricular contrast echocardiography. Thirty-seven coronary occlusions of up to 10 min in duration were carried out in proximal or distal locations in the left anterior descending and the left circumflex coronary arteries. Mitral regurgitation, which was mild in severity as judged by a small rise in pulmonary artery wedge pressures, was observed in 15 of 37 brief coronary occlusion experiments. Mitral valve prolapse was noted in all 15 experiments, as well as in four additional studies in which mitral regurgitation was not seen. The development of experimental mitral valve prolapse was explained by measurements that demonstrated a relative displacement of the papillary muscle tips toward the mitral orifice. We conclude that mitral valve prolapse is a common sequela of short-term coronary occlusion and is often associated with mild mitral regurgitation. Relative displacement of ischemic papillary muscles toward the mitral orifice appears to be a likely mechanism of acute ischemic mitral valve prolapse.