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缺血性左心室功能障碍患者血管重建术后收缩功能恢复的发生率。

Incidence of recovery of contractile function following revascularization in patients with ischemic left ventricular dysfunction.

作者信息

Schinkel Arend F L, Poldermans Don, Vanoverschelde Jean-Louis J, Elhendy Abdou, Boersma Eric, Roelandt Jos R T C, Bax Jeroen J

机构信息

Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Am J Cardiol. 2004 Jan 1;93(1):14-7. doi: 10.1016/j.amjcard.2003.09.005.

Abstract

Contractile function in patients with ischemic left ventricular (LV) dysfunction may improve after myocardial revascularization. Currently, the incidence of contractile function recovery after revascularization in these patients is unclear. The aim of this study was to assess the incidence of function improvement after myocardial revascularization in patients with ischemic LV dysfunction. A total of 258 consecutive patients (aged 59 +/- 12 years) with severely depressed LV ejection fractions (EFs) due to chronic coronary artery disease and heart failure symptoms were studied. All patients underwent radionuclide ventriculography and 2-dimensional echocardiography at rest before and 3 to 6 months after revascularization. At baseline, 1,330 segments (32%) were normal and 2,775 segments (68%) were dysfunctional. Improvement after revascularization occurred in 736 of the 2,775 dysfunctional segments (27%). Overall, LVEF improved from 29 +/- 7 to 32 +/- 9 (p <0.0001). A clinically significant improvement of LVEF (>/=5% postrevascularization) was present in 101 patients (39%). Improvement of LVEF after revascularization was frequently observed in patients with a more severely impaired baseline LVEF. At least 3 segments with improvement of function were needed for an improvement of LVEF of >/=5%.

摘要

缺血性左心室(LV)功能障碍患者的收缩功能在心肌血运重建后可能会改善。目前,这些患者血运重建后收缩功能恢复的发生率尚不清楚。本研究的目的是评估缺血性LV功能障碍患者心肌血运重建后功能改善的发生率。共研究了258例因慢性冠状动脉疾病和心力衰竭症状导致LV射血分数(EFs)严重降低的连续患者(年龄59±12岁)。所有患者在血运重建前静息状态下以及血运重建后3至6个月接受放射性核素心室造影和二维超声心动图检查。基线时,1330个节段(32%)正常,2775个节段(68%)功能障碍。血运重建后,2775个功能障碍节段中的736个(27%)出现改善。总体而言,LVEF从29±7提高到32±9(p<0.0001)。101例患者(39%)出现LVEF的临床显著改善(血运重建后≥5%)。血运重建后LVEF的改善在基线LVEF受损更严重的患者中经常观察到。LVEF提高≥5%需要至少3个节段的功能改善。

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