MITRAL VALVE DIMENSIONS IN VARIOUS CARDIAC CONDITIONS

为了评估左心室扩张对二尖瓣大小的影响， 这项研究比较了主动脉瓣狭窄患者二尖瓣的尺寸， 瓣膜疾病和肥厚性心肌病（HC）患者。 共 在手术或尸检时取出的216个瓣膜中， a）2组扩张性血管瘤患者的定量形态测量方法 左心室腔，即，17例主动脉瓣扩张患者 单纯主动脉瓣返流31例，B）2 没有扩张的左心室腔的患者组，即，29 非扩张型AS患者和94例HC患者，以及c）45例 没有心脏病的对照组。 平均二尖瓣瓣叶面积， 主动脉瓣狭窄伴左室腔扩大者12例（平均13.1 ± 3.0平方厘米）和AR（平均12.0 ± 3.6平方厘米）， 显著大于对照组（8.7 ± 2.0平方厘米; p小于0.001）。 主动脉瓣狭窄患者二尖瓣平均瓣叶面积 无扩张的左心室腔（9.8 ± 2.0平方cm） 与正常瓣膜（NS）相似。 然而，平均二尖瓣瓣叶面积 在HC患者中，左心室腔也 非扩张，显著更大（12.8 ± 3.7平方cm） 与非扩张型AS和正常人相比（p <0.001）。 因此，二尖瓣瓣叶面积增加：1）通常存在于 左心室扩张的主动脉瓣疾病患者， 似乎继发于左心室腔室扩张;和2） 不能归因于患者的左心室腔扩张 与HC，因为他们的腔是正常的或小的尺寸。 因此，在本发明中， HC中二尖瓣瓣叶面积增加，这被认为是主要的 心肌而不是瓣膜疾病，可能是由于对心脏的主要影响。 二尖瓣

To assess the effect of left ventricular dilatation on mitral valve size, this study compares dimensions of the mitral valve in patients with aortic valve disease and in those with hypertrophic cardiomyopathy (HC). A total of 216 valves, removed at operation or necropsy, was analyzed by quantitative morphometric methods from a) 2 patient groups with dilated left ventricular cavities, i.e., 17 patients with dilated valvular aortic stenosis (AS) and 31 patients with pure aortic regurgitation AR), b) 2 patient groups without dilated left ventricular cavities, i.e., 29 patients with nondilated AS and 94 patients with HC, and c) from 45 control subjects without heart disease. Mean mitral leaflet areas in patients with AS with dilated left ventricular cavities (mean 13.1 plus/minus 3.0 square cm) and AR (mean 12.0 plus/minus 3.6 square cm) were significantly greater than in the controls (8.7 plus/minus 2.0 square cm; p less than 0.001). Mean mitral leaflet area in the patients with AS without dilated left ventricular cavities (9.8 plus/minus 2.0 square cm) were similar to the normal valves (ns). However, mean mitral leaflet area in patients with HC, in whom left ventricular cavities were also nondilated, was significantly greater (12.8 plus/minus 3.7 square cm) compared to that in nondilated AS and in normals (p less than 0.001). Therefore, increased mitral leaflet area: 1) is commonly present in patients with aortic valve disease with dilated left ventricle in whom it appears to be secondary to left ventricular chamber dilatation; and 2) cannot be attributed to left ventricular cavity dilatation in patients with HC, since their cavities were of normal or small size. Thus, increased mitral leaflet area in HC, which is considered to be a primary myocardial and not valvular disease, may be due to a primary effect on the mitral valve.