Kobayashi T, Fudemoto Y, Yoshino T, Oda T, Fujimoto K, Hirose H, Kawashima Y
Department of Circulatory Dynamics, Center for Adult Diseases, Osaka, Japan.
Med J Osaka Univ. 1991 Mar;40(1-4):29-37.
Interventional left vertriculograms (LVGs) using postextrasystolic potentiation (PESP), nitroglycerin (TNG) and a combination of both were analyzed in order to decide the degree of efficacy of each intervention as a predictor of reversibility in impaired left ventricular segments. Segmental wall motion (SWM) in less severely impaired segments increased to the normal range and SWM in severely impaired segments increased but remained in the abnormal range after CABG. The effects of both PESP and TNG on SWM in impaired segments correlated (r = 0.78 and 0.78) with that of CABG. The increase in SWM due to TNG + PESP was significantly (p < 0.01) greater than that due to either PESP or TNG alone or that of CABG. Either PESP or TNG was clinically reliable for prediction of contractile reversibility in the segments with impaired wall motion prior to CABG. Including the global left ventricular function, PESP reflected the efficacy of CABG more sufficiently than TNG. TNG + PESP provoked more contractile reserve and exaggerated the results of CABG, but may predict reversibility in severely reduced wall motion.
为了确定每种干预措施作为左心室受损节段可逆性预测指标的疗效程度，对使用早搏后增强（PESP）、硝酸甘油（TNG）以及两者联合的介入性左心室造影（LVG）进行了分析。在冠状动脉旁路移植术（CABG）后，受损较轻节段的节段性室壁运动（SWM）增加至正常范围，而严重受损节段的SWM虽有增加但仍处于异常范围。PESP和TNG对受损节段SWM的影响与CABG的影响相关（r = 0.78和0.78）。TNG + PESP导致的SWM增加显著（p < 0.01）大于单独使用PESP或TNG或CABG导致的增加。在CABG前，PESP或TNG对于预测室壁运动受损节段的收缩可逆性在临床上是可靠的。包括整体左心室功能，PESP比TNG更充分地反映了CABG的疗效。TNG + PESP激发了更多的收缩储备并夸大了CABG的结果，但可能预测严重降低的室壁运动的可逆性。
