DILATED CARDIOMYOPATHY WITH MITRAL REGURGITATION - DECREASED SURVIVAL DESPITE A LOW-FREQUENCY OF LEFT-VENTRICULAR THROMBUS
DILATED CARDIOMYOPATHY WITH MITRAL REGURGITATION - DECREASED SURVIVAL DESPITE A LOW-FREQUENCY OF LEFT-VENTRICULAR THROMBUS
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DOI：
10.1016/0002-8703(91)90523-k
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发表时间：
1991-09-01
影响因子：
4.8
通讯作者：
PARRY, WR
中科院分区：
文献类型：
--
作者：
BLONDHEIM, DS;JACOBS, LE;PARRY, WR
本文应用二维、脉冲和彩色多普勒超声心动图对91例扩张型心肌病患者进行了研究：(1)检测和定量二尖瓣返流(MR)；(2)记录收缩和舒张期心尖部血流速度；(3)检测左室血栓。57%的患者发现MR，40%的患者存在血栓，但MR和血栓的发生率都很低(8%)。MR组的心尖血流速度在整个心动周期中显著升高(舒张期15+/-7vs9+/-7 cm/秒；收缩期29+/-12vs16+/-13 cm/秒；P<；两者均为0.001)，这是该组罕见血栓的原因。对89%的患者的随访数据显示，MR组的存活率显著降低(32+/-6个月时22%比60%，p<；0.005)，即使在轻度MR的患者中，这一点也很明显。因此，尽管MR是一种非侵入性的可获得的标记物，但它是一种敏感的标记物，表明扩张型心肌病患者的左室血栓形成受到保护。
Ninety-one patients with dilated cardiomyopathy were studied by two-dimensional, pulsed, and color Doppler echocardiography (1) to detect and quantify mitral regurgitation (MR), (2) to record apical flow velocities in systole and diastole, and (3) to detect the presence of left ventricular thrombi. MR was detected in 57% of the patients and thrombi were present in 40%, but the occurrence of both MR and thrombus was rare (8%). Apical flow velocity was significantly higher throughout the cardiac cycle in the group with MR (diastole 15 +/- 7 vs 9 +/- 7 cm/sec; systole 29 +/- 12 vs 16 +/- 13 cm/sec; p < 0.001 for both), accounting for the rarity of thrombi in this group. Follow-up data on 89% of the patients showed markedly decreased survival in the group with MR (22% vs 60% at 32 +/- 6 months, p < 0.005), and this was evident even in patients with mild MR. Thus although MR is a noninvasively obtainable marker of a large subgroup of patients with dilated cardiomyopathy "protected" from left ventricular thrombus formation, it is a sensitive marker of decreased survival.