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对20例风湿性二尖瓣狭窄(MS)患者,行经皮囊二尖瓣分离术(PBMV),应用左室心血管造影于PBMV前后行左室功能测定.结果显示PBMV前平均射血分数(EF)、舒张末期容量(EDV)、舒张末期容量指数(EDVI)、,心搏量(SV)、,心博指数(SI)、心输出量(CO)、心脏指数(CI)均低于正常值;PB-MV后,上述指标达到正常值.由于其中8例(40%)在PBMV前EF≤50%,故将20例患者分为两组进行对比研究,发现在PBMV前EF降低组(n=8)EDV、SV、CO、CI较EF正常组(n=12)低(P0.05).多元逐步回归分析显示,PBMV前后EDVI与EF关系最为密切.提示风湿性MS患者部分存在左室功能异常,主要为前负荷降低所致.
Peripheral ventricular mitral valve stenosis (PBMV) was performed in 20 patients with rheumatic mitral stenosis (MS) and left ventricular function was measured by left ventricular angiography before and after PBMV.The results showed that pre-PBMV ejection fraction (EF (EDV), end-diastolic volume index (EDVI), stroke volume (SV), cardiac index (SI), cardiac output (CO) and cardiac index (CI) After PB-MV, the above indexes reach the normal value.As eight patients (40%) had EF≤50% before PBMV, 20 patients were divided into two groups and compared. = 8) EDV, SV, CO and CI were lower than EF normal group (n = 12) (P <0.01 ~ 0.001). There was no significant difference of EF, EDV and CI between two groups after PBMV (P> 0.05). Multivariate stepwise regression analysis showed that EDVI was most closely related to EF before and after PBMV, suggesting that left ventricular dysfunction was found in some patients with rheumatic MS, mainly due to the decrease of preload.