Moraski R E, Russell R O, Smith M K, Rackley C E
Am J Cardiol. 1975 Jan;35(1):1-10. doi: 10.1016/0002-9149(75)90551-2.
Ninety-six patients with chest pain were studied to determine the relation between left ventricular function and severity of coronary artery disease in patients with and without a history of myocardial infarction. Coronary arteriography was performed obtaining cineangiograms (60 frames/sec) and large roll film angiograms (2 to 6 frames/sec) for precise definition of the coronary anatomy. The criteria for diagnosis of myocardial infarction were a typical history, a rise and fall in serum glutamic oxaloacetic transaminase levels and evolutionary S-T segment changes associated with Q waves of at least 0.03 second. Left ventricular function was assessed by measurement of left ventricular end-diastolic pressure and volume, and left ventricular ejection fraction, mass and compliance. Fifteen patients had normal findings; 81 were classified according to number of diseased vessels and presence or absence of myocardial infarction. There were no group differences in age or heart rate. Left ventricular end-diastolic pressure was abnormally increased in patients with three vessel disease and myocardial infarction. Left ventricular end-diastolic volume was increased and the ejection fraction was reduced in patients in each vessel disease group with myocardial infarction. Although ejection fraction was reduced in patients with three vessel disease without myocardial infarction, it was further reduced when infarction occurred. Left ventricular mass increased in patients with three vessel disease with or without myocardial infarction. Values for ventricular compliance were reduced in all patients with myocardial infarction and were lower in those with two and three vessel disease and infarction than in those with two and three vessel disease without infarction. These findings suggest that a previous history of myocardial infarction needs to be considered together with anatomic abnormalities of the coronary arteries in assessing cardiac performance in patients with ischemic heart disease, a previous myocardial infarction significantly alters left ventricular performance; the ejection fraction is a more sensitive measurement of left ventricular function than left ventricular end-diastolic pressure or volume.
对96例胸痛患者进行了研究，以确定有或无心肌梗死病史的患者左心室功能与冠状动脉疾病严重程度之间的关系。进行了冠状动脉造影，获取电影血管造影（每秒60帧）和大卷片血管造影（每秒2至6帧），以精确界定冠状动脉解剖结构。心肌梗死的诊断标准为典型病史、血清谷草转氨酶水平的升高和下降以及与至少0.03秒Q波相关的演变性S-T段改变。通过测量左心室舒张末期压力和容积、左心室射血分数、质量和顺应性来评估左心室功能。15例患者检查结果正常；81例根据病变血管数量和有无心肌梗死进行分类。各年龄组和心率无差异。三支血管病变合并心肌梗死的患者左心室舒张末期压力异常升高。每支血管病变合并心肌梗死的患者左心室舒张末期容积增加，射血分数降低。虽然无心肌梗死的三支血管病变患者射血分数降低，但发生梗死后进一步降低。有或无心肌梗死的三支血管病变患者左心室质量增加。所有心肌梗死患者的心室顺应性值均降低，两支血管病变和三支血管病变合并梗死的患者的心室顺应性值低于两支血管病变和三支血管病变但无梗死的患者。这些发现表明，在评估缺血性心脏病患者的心脏功能时，需要将既往心肌梗死病史与冠状动脉解剖异常一并考虑；既往心肌梗死会显著改变左心室功能；射血分数是比左心室舒张末期压力或容积更敏感的左心室功能测量指标。
