Prevalence of mitral valve prolapse in normal children.
Prevalence of mitral valve prolapse in normal children.
复制标题
正常儿童二尖瓣脱垂的患病率。
DOI：
10.1016/s0735-1097(85)80021-8
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发表时间：
1985
影响因子：
24
通讯作者：
A. Weyman
中科院分区：
文献类型：
--
作者：
D. Warth;M. E. King;J. Cohen;V. L. Tesoriero;E. Marcus;A. Weyman
虽然超声心动图已成为诊断二尖瓣脱垂的标准非侵入性方法，但诊断标准尚未明确定义二尖瓣关闭的正常模式范围。本研究分析了193名儿童（年龄5天至18岁）的二尖瓣关闭模式，这些儿童通过病史和体格检查进行筛查，以排除结构性心脏病，分析了二尖瓣收缩期瓣叶位置，以观察瓣叶上级于瓣环平面的任何部分。在整个研究组的13%中观察到上级收缩运动;这种模式在婴儿中不常见，但在年龄较大的儿童中更常见，10至18岁年龄组的患病率为35%。在任何年龄段，男女儿童之间都没有统计学上的显著差异。如果考虑到上级收缩期运动出现在多个超声心动图视图（1%）或二尖瓣瓣叶接合点移位（0.5%），则其发生率显著降低。正常儿童出现上级收缩期运动的频率如此之高，以至于人们对这种二尖瓣关闭模式作为二尖瓣脱垂诊断标准的可靠性提出了质疑。可能需要考虑瓣叶移位程度或其在多个超声心动图视图中的存在的更严格的诊断标准，以识别二尖瓣关闭模式真正超出正常范围的受试者。
Although echocardiography has become the standard noninvasive method of diagnosing mitral valve prolapse, the diagnostic criteria have been established without clearly defining the range of normal patterns for mitral valve closure. The current study reports the analysis of mitral valve closure patterns in 193 children (aged 5 days to 18 years) making scheduled visits for well child care who were screened by history and physical examination to exclude structural heart disease.Mitral valve systolic leaflet position was analyzed for the appearance of any portion of either leaflet superior to the plane of the anulus. Superior systolic motion was noted in 13% of the overall study group; this pattern was uncommon in infants but more frequent in older children, with a prevalence of 35% in the 10 to 18 year age group. There was no statistically significant difference between male and female children at any age. The prevalence of superior systolic motion decreased markedly if consideration was given to its presence in more than one echocardiographic view (1%) or to displacement of the coaptation point of the mitral valve leaflets (0.5%).Superior systolic motion occurs with such frequency in normal children as to call into question the reliability of this pattern of mitral valve closure as a standard for the diagnosis of mitral valve prolapse. More restrictive diagnostic criteria which consider the degree of leaflet displacement or its presence in multiple echocardiographic views may be necessary to identify those subjects whose mitral valve closure patterns truly fall outside the range of normal.