心エコー法による僧帽弁逸脱症の研究
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概要
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In order to investigate the aspects and the mechanisms of mitral valve prolapse (MVP) and the etiologic mechanisms of its M-mode echocardiographic findings, echocardiographic observations were made in 87 patients with idiopathic MVP and 25 patients with secundum type atrial septal defect (ASD) associated with MVP. The following results were obtained. 1. The anterior leaflet prolapse waS found more frequently than the posterior leaflet prolapse contrary to the angiocardiographic reports that the prolapse mainly occurs in posterior leaflet. 2. Of 32 patients with idiopathic MVP whose prolapse side could be detected, 11 patients were found to have their prolapse limited to the medial side, only 2 patients to the lateral side, and the remainders had the prolapse on both sides. 3. Regarding the M-mode echocardiographic findings of idiopathic MVP, pansystolic bowing or midsystolic buckling was observed in all patients with pansystolic anterior mitral leaflet prolapse, while no patient with posterior mitral leaflet prolapse showed pansystolic bowing and only a few patients showed midsystolic buckling. Patients with chordal rupture did not show the typical pansystolic bowing or midsystolic buckling. Systolic layered echoes were observed in most patients with MVP. 4. Decreased motion of the posterior leaflet probably due to its thickening was observed in patients with ASD associated with MVP. In addition, it was indicated that the degree of thickening of posterior leaflet was higher in proportion to the patients' age and the degree of left-to-right shunting. 5. In 8 of 11 ASD patients associated with MVP whose M-mode echocardiogram indicated neither pansystolicbowing nor midsystolic buckling, such a posterior leaflet change was found, while none of 8 cases with echocardiographically demonstrable pansystolic bowing revealed any posterior leaflet change.
- 神戸大学の論文