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首页> 外文期刊>Journal of cardiac surgery. >LDH levels and left atrial ultrastructural chances in patients with mitral paraprosthetic regurgitation.
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LDH levels and left atrial ultrastructural chances in patients with mitral paraprosthetic regurgitation.

机译：二尖瓣副瓣关闭不全患者的LDH水平和左心房超微结构机会。

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BACKGROUND AND AIM: The aim of this study was to assess the effect of paraprosthetic regurgitation of mitral mechanical valves to myocardial tissue and lactate dehydrogenase (LDH) level. METHODS: We compared 19 patients (study group) who had mitral mechanical valve with severe mitral paravalvular regurgitation with 20 patients (control group) who had native valve with severe rheumatic mitral regurgitation. None of the patients had clinical hemolytic anemia. On transesophageal echocardiographic examination, semiquantative evaluation and spatial distribution of regurgitant jets were noted in both of the groups. Five LDH isoenzymes were studied in two groups. Myocardial tissue specimens were taken from the left atrial wall during reoperation. Grids randomly taken were studied under the transmission electron microscope. RESULTS: Total serum LDH levels of the study group (578 +/- 12 IU/L) were higher than the control group (495 +/- 6.2 IU/L) (p < 0.001). We found LDH1/LDH2 more than 1 in all patients; the ratio was not statistically different in the control group. Electron microscopy revealed the same degree of injury in both groups. Haptoglobin levels were decreased and reticulocyte counts were increased in patients with paraprosthetic valve regurgitation. Conclusions: Electron microscopic findings support that myocardial injury contributes to increase of total LDH level and high LDH1/LDH2 ratio. But statistically significant elevation in total LDH level in study group and the stable state of LDH1/LDH2 ratio between two groups showed that hemolysis caused by paraprosthetic regurgitation is the most important factor for the increase of total LDH level, so that high LDH level can be used as a reliable parameter for the diagnosis of intravascular hemolysis in paraprosthetic regurgitation.
机译：背景与目的：这项研究的目的是评估二尖瓣机械瓣人工副瓣反流对心肌组织和乳酸脱氢酶（LDH）水平的影响。方法：我们将19例二尖瓣机械瓣严重二尖瓣瓣关闭不全的患者（20例）与20例自然瓣膜严重风湿性二尖瓣关闭不全的患者（对照组）进行了比较。没有患者发生临床溶血性贫血。经食管超声心动图检查时，两组均观察到反流喷射的半定量评估和空间分布。两组研究了5种LDH同工酶。再次手术时从左心房壁取心肌组织标本。在透射电子显微镜下研究了随机取的网格。结果：研究组的总血清LDH水平（578 +/- 12 IU / L）高于对照组（495 +/- 6.2 IU / L）（p <0.001）。我们发现所有患者中的LDH1 / LDH2均大于1。对照组的比率无统计学差异。电子显微镜显示两组的损伤程度相同。人工瓣膜返流患者的血红蛋白水平降低，网织红细胞计数增加。结论：电子显微镜检查结果支持心肌损伤有助于增加总LDH水平和提高LDH1 / LDH2比例。但是研究组总LDH水平的升高和两组之间LDH1 / LDH2比率的稳定状态在统计学上具有显着意义，表明假体返流引起的溶血是增加总LDH水平的最重要因素，因此高LDH水平可以用作辅助假体返流中血管内溶血诊断的可靠参数。

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