Assanelli D, Marconi M, Gei P, Zappa C, Leonzi O, Ettori F, Niccoli L
Chair of Cardiology, University of Brescia, Italy.
Acta Cardiol. 1992;47(1):65-70.
Prognostic and clinical characteristics of acute myocardial infarction (AMI) can usually justify surgical and/or angioplastic approach if the residual ventricular function is still good. Multivessel disease frequently complicates results interpretation. We studied with 2D echocardiography and coronary angiography two groups of patients with one vessel stenosis located on anterior descending (AD) and previous AMI (means 19 days): 23 patients with spontaneous non-Q infarction (group 1), and 23 patients with Q infarction. Left ventricular function was better in group 1. Percent occlusion of AD was lower in group 1 and angiographic AD caliber was significantly higher. Differences between groups were much more evident in subgroups with proximal stenosis of AD: patients of non-Q subgroups had very good left ventricular function but frequently had post-AMI instable angina (88%). Our results underline the usefulness of aggressive diagnostic and therapeutic approach in non-Q AMI, because of higher amount of myocardium at risk.
如果残余心室功能仍然良好，急性心肌梗死（AMI）的预后和临床特征通常可证明手术和/或血管成形术治疗的合理性。多支血管病变常常使结果解释变得复杂。我们使用二维超声心动图和冠状动脉造影对两组患者进行了研究，这两组患者均有位于前降支（AD）的单支血管狭窄且既往有AMI（平均19天）：23例自发性非Q波梗死患者（第1组）和23例Q波梗死患者。第1组的左心室功能更好。第1组AD的闭塞百分比更低，且血管造影显示AD管径明显更大。在AD近端狭窄的亚组中，两组之间的差异更为明显：非Q波亚组的患者左心室功能非常好，但经常发生AMI后不稳定型心绞痛（88%）。我们的结果强调了在非Q波AMI中采取积极诊断和治疗方法的有用性，因为处于危险中的心肌量更大。
