Singh B K, Chaudhry F A
College of Physicians and Surgeons, Columbia University, St Luke's-Roosevelt Hospital, New York, NY 10025, USA.
Prog Cardiovasc Dis. 2001 Jan-Feb;43(4):351-61. doi: 10.1053/pcad.2001.20500.
Left ventricular function is one of the most important determinates of long-term prognosis in patients with coronary artery disease. In recent years, it has become apparent that left ventricular dysfunction in patients with coronary artery disease is not always an irreversible process stemming from myocardial necrosis and fibrosis. Myocardial tissue can undergo both a state of potential reversible dysfunction because of prolonged sustained ischemia (hibernating myocardium) or episodes of acute ischemia (stunned myocardium). Revascularization of this tissue may improve regional and global left ventricular function and therefore prognosis. Numerous studies have now firmly established dobutamine echocardiography as a safe, reliable, and accurate imaging modality in the assessment of reversible left ventricular dysfunction. Furthermore, dobutamine echocardiography has been shown to have good sensitivity, specificity, and, more importantly, positive predictive accuracy in identifying both acute and chronic reversible left ventricular dysfunction for risk satisfaction and prognosis.
左心室功能是冠心病患者长期预后的最重要决定因素之一。近年来，越来越明显的是，冠心病患者的左心室功能障碍并不总是源于心肌坏死和纤维化的不可逆过程。由于长期持续性缺血（冬眠心肌）或急性缺血发作（顿抑心肌），心肌组织可能会经历潜在可逆性功能障碍状态。该组织的血运重建可能会改善左心室局部和整体功能，从而改善预后。目前，大量研究已明确将多巴酚丁胺超声心动图作为评估可逆性左心室功能障碍的一种安全、可靠且准确的成像方式。此外，多巴酚丁胺超声心动图在识别急性和慢性可逆性左心室功能障碍以评估风险和预后方面，已显示出良好的敏感性、特异性，更重要的是，具有阳性预测准确性。
