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首页> 外文期刊>Journal of cardiovascular medicine >Mitral regurgitation and dyspnoea: the expanding role of mitral effective regurgitant orifice among un-selected patients
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Mitral regurgitation and dyspnoea: the expanding role of mitral effective regurgitant orifice among un-selected patients

机译：二尖瓣反流和呼吸困难：未选择患者二尖症有效反流孔的扩展作用

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Aims Mitral regurgitation is frequent in the general population and among suspected heart failure patients; however, to what extent it contributes to dyspnoea is unclear. We hypothesized mitral regurgitation to have a role in determining dyspnoea in unselected ambulatory patients. Methods Consecutive outpatients referred for echocardiography were retrospectively screened and included. We excluded patients with mitral stenosis or prosthesis, congenital heart disease, cardiac surgery (previous 6 months) and atrial fibrillation. Patients were classified into four dyspnoea grades based on how they perceived their disability. We assessed mitral regurgitation severity through the effective regurgitant orifice area (ERO). Results One hundred and fifty-four patients (58% men; age 67 +/- 14 years; mean ejection fraction 54 +/- 12%) formed the study population; 76 (49%) classified asymptomatic (grade I), 63 (41%) dyspnoea grade II and 15 (10%) grade III; none was in grade IV. Mitral regurgitation was present in 102 patients (66%): primary in 14 (14%) and secondary in 88 (86%); among grades I, II and III patients, mitral regurgitation was present in 35 (46%; ERO 0.05 +/- 0.10 cm(2)), 52 (82%; ERO 0.10 +/- 0.13 cm(2)) and 15 (100%; ERO 0.20 +/- 0.11 cm(2)) patients, respectively (P < 0.0001). After adjusting for clinical (age, hypertension, ischemic heart disease, chronic kidney injury, chronic pulmonary disease) and echocardiographic confounders (ejection fraction, E/e'), ERO remained associated with symptoms presence (grade I versus II - III;P = 0.01 andP = 0.03, respectively). Conclusion Among unselected heterogeneous ambulatory patients, mitral ERO was associated with the presence of dyspnoea and could therefore help in identifying symptomatic patients and in clinical characterization of patients with perceived dyspnoea.
机译：目的二尖瓣返流在普通人群和疑似心力衰竭患者中很常见；然而，它在多大程度上导致呼吸困难尚不清楚。我们假设二尖瓣返流在未经选择的非卧床患者的呼吸困难中起作用。方法回顾性筛选并纳入连续门诊接受超声心动图检查的患者。我们排除了二尖瓣狭窄或假体、先天性心脏病、心脏手术（前6个月）和心房颤动的患者。根据患者对自身残疾的认知，将患者分为四个呼吸困难等级。我们通过有效返流口面积（ERO）评估二尖瓣返流的严重程度。结果154名患者（58%为男性，年龄67+/-14岁，平均射血分数54+/-12%）构成研究人群；76（49%）分为无症状（I级）、63（41%）分为呼吸困难II级和15（10%）分为III级；无一例为IV级。102例患者（66%）出现二尖瓣返流：原发性14例（14%），继发性88例（86%）；在I、II和III级患者中，分别有35例（46%；ERO 0.05+/-0.10 cm（2））、52例（82%；ERO 0.10+/-0.13 cm（2））和15例（100%；ERO 0.20+/-0.11 cm（2））患者出现二尖瓣反流（P<0.0001）。在调整临床（年龄、高血压、缺血性心脏病、慢性肾损伤、慢性肺疾病）和超声心动图混杂因素（射血分数、E/E'）后，ERO仍然与症状存在相关（I级与II-III级；分别为P=0.01和P=0.03）。结论在未经选择的异质性非卧床患者中，二尖瓣ERO与呼吸困难的存在相关，因此有助于识别有症状的患者，并有助于识别感知呼吸困难患者的临床特征。

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