僧帽弁逸脱症候群の臨床像ならびに予後に関する研究
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概要
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Two hundred and twenty patients with mitral valve prolapse (MVP) were studied clinically and echocardiographically. The severity of MVP classified into 5 grades by twodimensional echocardiography was compared with the severity of mitral regurgitation (MR) and with other clinical features. In patients with severe prolapse (grade IV〜V) who had moderate or severe MR, dilated left ventricle and/or left atrium were observed. On the other hand, in patients with mild prolapse (less than grade III) MR was detected in mild degree or absent and any left ventricular volume overload was not observed. However, there was no relationship between the severity of prolapse and incidence of symptoms and ECG abnormalities, and serious ventricular arrhythmias were frequently detected not only in severe prolapse group but also in mild prolapse group. In: the follow-up study for more than one year (mean observation period 3.1 years) of 84 patients with MVP, aggravation of M-mode echocardiographic parameters (LVDd, LAD, and %FS) was observed in 14 patients, consisting of 8 patients with severe prolapse and 6 patients with mild prolapse. And clinical findings such as ST-T abnormalities in ECG, serious ventricular arrhythmias and low response of left ventricle in exercise echocardiography were detected in almost same incidence in mild prolapse group as in severe prolapse group. The aggravation in the severe prolapse group seems to be caused by severe MR, but in the mild prolapse group other factors than volume overload are playing an important role in the aggravation. Thus, careful management should be done not only for severe MVP, but also for mild MVP with clinical findings such as symptoms, ECG abnormalities, or serious arrhythmias.
- 神戸大学の論文