Ueno Yoshiki, Nakamura Yasuyuki, Kinoshita Masahiko, Fujita Tamotsu, Sakamoto Taizou, Okamura Hiroshi
The First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Otsu, Shiga, Japan.
Echocardiography. 2002 Oct;19(7 Pt 1):555-63. doi: 10.1046/j.1540-8175.2002.00555.x.
Several studies have demonstrated that the ratio of peak E wave velocity/flow propagation velocity (E/FPV) using color M-mode Doppler echocardiography and the mitral E wave deceleration time make it possible to estimate left ventricular filling pressure. Recent studies have indicated that deceleration time can predict left ventricular dilation after acute myocardial infarction. The purpose of this study was to determine whether the early assessment of deceleration time and E/FPV could predict left ventricular dilation after acute myocardial infarction. We studied 55 patients with first anterior acute myocardial infarction who underwent successful coronary angioplasty by two-dimensional (2-D) Doppler echocardiography within 12 hours and at 1 and 6 months after reperfusion. Patients were divided into three groups according to deceleration time and E/FPV immediately after reperfusion: (1). restrictive filling (deceleration time < 140 msec and E/FPV > or= 2.0), (2). elevated filling pressure (deceleration time >or= 140 msec and E/FPV >or= 2.0), (3). and normal filling pressure (deceleration time >or= 140 msec and E/FPV < 2.0). The end-diastolic volume index (EDVI) was similar in the three groups immediately after reperfusion. EDVI in the groups with restrictive filling and elevated filling pressure was significantly greater than that in the group with normal filling pressure at 6 months (93 +/- 11 and 89 +/- 16 vs 59 +/- 11 ml/m(2), respectively; P < 0.0001). E/FPV shows a better correlation with the change in EDVI at 6 months than deceleration time (r = 0.77; P < 0.0001 and r = - 0.46; P < 0.001, respectively). The early measurement of E/FPV provides a simple and accurate means for predicting left ventricular dilation after acute myocardial infarction.
多项研究表明，应用彩色M型多普勒超声心动图测量的E波峰值速度与血流传播速度之比（E/FPV）以及二尖瓣E波减速时间能够用于估算左心室充盈压。近期研究指出，减速时间可预测急性心肌梗死后左心室扩张情况。本研究的目的是确定对减速时间和E/FPV进行早期评估能否预测急性心肌梗死后左心室扩张。我们研究了55例首次发生前壁急性心肌梗死且在再灌注后12小时内以及1个月和6个月时接受二维（2-D）多普勒超声心动图检查的患者，这些患者均成功接受了冠状动脉成形术。根据再灌注后即刻的减速时间和E/FPV将患者分为三组：（1）. 限制性充盈（减速时间<140毫秒且E/FPV≥2.0），（2）. 充盈压升高（减速时间≥140毫秒且E/FPV≥2.0），（3）. 以及正常充盈压（减速时间≥140毫秒且E/FPV<2.0）。再灌注后即刻，三组的舒张末期容积指数（EDVI）相似。6个月时，限制性充盈组和充盈压升高组的EDVI显著高于正常充盈压组（分别为93±11和89±16 vs 59±11 ml/m²；P<0.0001）。与减速时间相比，E/FPV与6个月时EDVI的变化具有更好的相关性（r = 0.77；P<0.0001和r = -0.46；P<0.001）。对E/FPV进行早期测量为预测急性心肌梗死后左心室扩张提供了一种简单且准确的方法。
