Kanamasa K, Nakabayashi T, Hayashi T, Inoue Y, Ikeda A, Morii H, Naito N, Ishikawa K
First Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan.
Angiology. 2000 Apr;51(4):281-8. doi: 10.1177/000331970005100402.
The authors investigated the capacity of percutaneous transluminal coronary angioplasty (PTCA) performed 24-48 hours after the onset of acute myocardial infarction (AMI) to improve regional left ventricular wall motion. Twenty-four patients were divided into two groups: a PTCA group who received successful PTCA (14 cases) and a non-PTCA group (10 cases) who did not receive PTCA. Left ventricular end-diastolic volume (LVEDV) increased significantly (p<0.01) from 57+/-14 mL/m2 during the acute phase to 83+/-16 mL/m2 during the chronic phase in the non-PTCA group, whereas no significant change in LVEDV was seen in the PTCA group (69+/-26 vs. 76+/-16 mL/m2). In addition, in patients with 99% stenosis/thrombolysis in myocardial infarction (TIMI) grade 3 flow, increases in regional left ventricular wall motion (delta(sd)/chord) at the infarcted site between the acute and chronic phases were significantly greater in the PTCA group than in the non-PTCA group (2.49+/-1.05 vs. 0.67+/-0.65, p<0.01). PTCA performed 24-48 hours after the onset of AMI improved wall motion at the infarcted site.
作者研究了急性心肌梗死(AMI)发病后24 - 48小时进行的经皮腔内冠状动脉成形术(PTCA)改善左心室局部壁运动的能力。24例患者分为两组:成功接受PTCA的PTCA组(14例)和未接受PTCA的非PTCA组(10例)。非PTCA组左心室舒张末期容积(LVEDV)从急性期的57±14 mL/m²显著增加(p<0.01)至慢性期的83±16 mL/m²,而PTCA组LVEDV未见显著变化(69±26 vs. 76±16 mL/m²)。此外,在心肌梗死(TIMI)3级血流狭窄99%/溶栓的患者中,PTCA组梗死部位急性期至慢性期局部左心室壁运动(delta(sd)/弦)的增加显著大于非PTCA组(2.49±1.05 vs. 0.67±0.65,p<0.01)。AMI发病后24 - 48小时进行的PTCA改善了梗死部位的壁运动。