Cacciapuoti F, D'Avino M, Lama D, Sepe J, Varricchio M
Department of Geriatrics, First Faculty of Medicine, Naples University, Napoli, Italy.
Echocardiography. 1991 May;8(3):345-52. doi: 10.1111/j.1540-8175.1991.tb01198.x.
To define the availability of Doppler echocardiography in evaluating left ventricular hemodynamic changes induced by some clinical findings of acute coronary insufficiency, we selected 12 patients with angina and 32 affected by acute myocardial infarction. Doppler echocardiography was performed at hospital admittance and during recovery time. Left ventricular contractility was defined on the systolic aortic flow spectrum by measuring the aortic velocity maximum, the time to peak/left ventricular ejection time ratio, and the cardiac output. During the first examination, left ventricular contractility significantly decreased in patients with angina and in those with acute myocardial infarction. After the acute phase, these parameters slightly improved. Left ventricular diastolic filling was evaluated in the transmitral flow. A decreased E-wave velocity and an increased late component (A wave) with inversion of the E/A wave ratio were found in patients with acute myocardial infarction during the first examination. This morphology inverts when the patients stabilize. On the contrary, this ratio stayed above one during and after angina. In this study, we also defined the usefulness of the color Doppler method in setting up criteria to identify some early morphological complications of acute myocardial infarction in 12 patients with acute infarction and a new systolic murmur. This technique showed an ischemic rupture of the ventricular septum in five cases and mitral regurgitation in seven. The color Doppler method has allowed us to obtain a semi-quantitative assessment of the mitral regurgitation and the location of the ventricular septal defect.
为了确定多普勒超声心动图在评估急性冠状动脉供血不足的某些临床发现所引起的左心室血流动力学变化方面的可用性，我们选择了12例心绞痛患者和32例急性心肌梗死患者。在入院时和恢复期间进行多普勒超声心动图检查。通过测量主动脉最大流速、峰值时间/左心室射血时间比值和心输出量，根据收缩期主动脉血流频谱定义左心室收缩力。在首次检查时，心绞痛患者和急性心肌梗死患者的左心室收缩力显著降低。急性期过后，这些参数略有改善。通过二尖瓣血流评估左心室舒张期充盈情况。在首次检查时，急性心肌梗死患者发现E波速度降低，晚期成分（A波）增加，E/A波比值倒置。当患者病情稳定时，这种形态会反转。相反，在心绞痛发作期间及发作后，该比值保持在1以上。在本研究中，我们还确定了彩色多普勒方法在制定标准以识别12例急性梗死并伴有新的收缩期杂音患者的急性心肌梗死一些早期形态学并发症方面的有用性。该技术在5例中显示室间隔缺血性破裂，7例中显示二尖瓣反流。彩色多普勒方法使我们能够对二尖瓣反流和室间隔缺损的位置进行半定量评估。
