Left atrial size, pressure, and V wave height in patients with isolated, severe, pure mitral regurgitation.
Left atrial size, pressure, and V wave height in patients with isolated, severe, pure mitral regurgitation.
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孤立性严重单纯二尖瓣反流患者的左心房大小、压力和 V 波高度。
DOI：
10.1002/ccd.1810100505
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
A. Tortolani
中科院分区：
文献类型：
--
作者：
R. Pizzarello;J. Turnier;V. Padmanabhan;M. Goldman;A. Tortolani
近年来，有关二尖瓣反流综合征的病因学和血流动力学的一些概念发生了变化。冠状动脉疾病和二尖瓣脱垂已取代风湿性心脏病成为二尖瓣反流的最常见原因。血流动力学研究表明，肺毛细血管楔形描记中的高 V 波对于检测二尖瓣反流的存在既不特异也不敏感。在这项研究中，我们评估了各种临床、超声心动图和血流动力学结果在左心房 (LA) 大小、压力和 V 波高度方面的作用。我们发现，急性二尖瓣反流患者的平均肺毛细血管楔压（PCW）和 V 波高度（PCW = 24.1 +/- 10.9；V = 41.2 +/- 20.7 mm Hg）与慢性二尖瓣反流患者的亚组相似（PCW = 17.9 +/- 7.5；V = 32.0 +/- 18.2 mm Hg）。此外，我们发现 LA 大小与二尖瓣反流持续时间之间存在显着的对数关系（y = 1.404 [log X] + 3.948；R = 0.678；p 小于 0.0005）。最后，我们发现 LA 大小、顺应性、反流量和反流瓣膜孔面积都随着时间的推移而增加。
In recent years, some concepts regarding the etiology and hemodynamics present in the syndrome of mitral regurgitation have changed. Coronary artery disease and mitral valve prolapse have replaced rheumatic heart disease as the most frequent cause of mitral regurgitation. Hemodynamic studies have shown that tall V waves in the pulmonary capillary wedge tracings are neither specific nor sensitive in detecting the presence of mitral regurgitation. In this study, we evaluated the role of various clinical, echocardiographic, and hemodynamic findings with regard to left atrial (LA) size, pressure, and V wave height. We found that the mean pulmonary capillary wedge pressure (PCW) and V wave height for the subset of patients with acute mitral regurgitation (PCW = 24.1 +/- 10.9; V = 41.2 +/- 20.7 mm Hg) was similar to the subset with chronic mitral regurgitation (PCW = 17.9 +/- 7.5; V = 32.0 +/- 18.2 mm Hg). In addition, we found that there was a significant logarithmic relationship between the LA size and the duration of the mitral regurgitation (y = 1.404 [log X] + 3.948; R = 0.678; p less than 0.0005). Lastly, we found that LA size, compliance, regurgitant volume, and regurgitant valve orifice area all increase with time.