Jeetley Paramjit, Swinburn Jonathan, Hickman Michael, Bellenger Nick G, Pennell Dudley J, Senior Roxy
Department of Cardiovascular Medicine, Northwick Park Hospital, and Institute for Medical Research, London, United Kingdom.
J Am Soc Echocardiogr. 2004 Oct;17(10):1030-6. doi: 10.1016/j.echo.2004.06.020.
We investigated whether the extent of residual myocardial viability demonstrated by myocardial contrast echocardiography (MCE) predicts the degree of left ventricular (LV) remodelling after acute myocardial infarction as assessed by cardiovascular magnetic resonance.
Accordingly, 25 patients underwent MCE 5 to 7 days after acute myocardial infarction followed by cardiovascular magnetic resonance assessment of LV end-diastolic volume, LV end-systolic volume, and LV ejection fraction. A contrast perfusion index was calculated within the infarct-related territory.
LV end-diastolic and end-systolic volumes were significantly smaller (138 +/- 38 vs 188 +/- 43 mL, P =.008, and 86 +/- 35 vs 119 +/- 49 mL, P =.01, respectively) and LV ejection fraction was significantly higher (52 +/- 5.4 vs 31.5 +/- 3.2%, P> =.02) in patients showing good myocardial viability (contrast perfusion index </= 1.5) compared with those without viability. MCE was the only multivariate predictor of LV volumes and LV ejection fraction at 2 weeks and 6 months.
The extent of residual myocardial viability as demonstrated by MCE predicts the degree of LV remodelling after acute myocardial infarction.
我们研究了心肌对比超声心动图（MCE）所显示的残余心肌存活程度是否能预测急性心肌梗死后左心室（LV）重构的程度，该程度通过心血管磁共振进行评估。
因此，25例患者在急性心肌梗死后5至7天接受了MCE检查，随后通过心血管磁共振评估左心室舒张末期容积、左心室收缩末期容积和左心室射血分数。在梗死相关区域计算对比灌注指数。
与无存活心肌的患者相比，显示出良好心肌存活（对比灌注指数≤1.5）的患者左心室舒张末期和收缩末期容积显著更小（分别为138±38 vs 188±43 mL，P = 0.008，以及86±35 vs 119±49 mL，P = 0.01），左心室射血分数显著更高（52±5.4 vs 31.5±3.2%，P≥0.02）。MCE是2周和6个月时左心室容积和左心室射血分数的唯一多变量预测因子。
MCE所显示的残余心肌存活程度可预测急性心肌梗死后左心室重构的程度。
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