Kuznetsov V A, Kuznetsova N I, Loginov O L, Osokin S A, Shalaev S V, Gizatulina T P
Institute Clinical & Preventive Cardiology, Tyumen, Russia.
Rev Port Cardiol. 1992 Dec;11(12):1125-31.
To evaluate the association between left ventricular false tendon (LVFT) and ventricular arrhythmias in acute myocardial infarction (MI) on the 1-st day of acute MI 71 patients were examined by 24-hour ECG-monitoring and M-mode, two-dimensional, Doppler echocardiography. LVFT was detected in 30 patients (42.3%). The frequency of left ventricular fibrillation, the number of patients with multiform ectopic ventricular beats (EVB), the number of single and pair EVB and runs of ventricular tachycardia were greater in group of patients with LVFT. 37 patients had Lown grades 1-2 (A) of arrhythmias, 34 patients had grades 3-5 (B). LVFT was revealed in four patients in group A (10.8%) and in 27 patients in group B (76.5%, p < 0.001). There were no significant differences between groups in left ventricular asynergy area and wall motion score, left and right ventricular, left atrium dimensions, left ventricular contractility indices, left ventricular walls thickness, frequency of mitral regurgitation. Multifactor analysis has shown significant relationship between Lown's class value and LVFT (p < 0.0001), Lown's class and arterial hypertension (p = 0.0376). Other 17 clinical factors were not connected with Lown's class value. Thus, LVFT was associated with severe ventricular arrhythmias in patients with AMI. This fact can be used as a predictor of these disturbances.
为评估急性心肌梗死(MI)第1天左心室假腱索(LVFT)与室性心律失常之间的关联,对71例患者进行了24小时心电图监测以及M型、二维、多普勒超声心动图检查。30例患者(42.3%)检测到LVFT。LVFT患者组的左心室颤动频率、多形性室性早搏(EVB)患者数量、单发和成对EVB数量以及室性心动过速发作次数更多。37例患者心律失常为Lown 1 - 2级(A组),34例患者为3 - 5级(B组)。A组4例患者(10.8%)发现有LVFT,B组27例患者(76.5%,p < 0.001)发现有LVFT。两组在左心室协同失调面积和壁运动评分、左心室和右心室、左心房尺寸、左心室收缩指数、左心室壁厚度、二尖瓣反流频率方面无显著差异。多因素分析显示Lown分级值与LVFT之间存在显著关系(p < 0.0001),Lown分级与动脉高血压之间存在显著关系(p = 0.0376)。其他17个临床因素与Lown分级值无关。因此,LVFT与急性心肌梗死患者的严重室性心律失常有关。这一事实可作为这些紊乱的预测指标。