Iga K, Hori K, Kitaguchi K, Matsumura T, Gen H, Tomonaga G, Tamamura T
Department of Cardiology, Tenri Hospital, Japan.
Jpn Circ J. 1991 Nov;55(11):1061-7. doi: 10.1253/jcj.55.1061.
Eight cases of transient reversible segmental asynergy of the left ventricle thought not to be related to coronary artery lesions are reported. Three cases were associated with inflammatory reactions of unknown origin, and one each with lactic acidosis, abdominal surgery, hypoglycemia, tetanus and pneumonia. None of the patients had symptoms suggestive of ischemic heart disease before or after these episodes. Electrocardiograms before these episodes were all normal. Two-dimensional echocardiography was performed to evaluate abnormal electrocardiograms. Coronary angiography was performed in 4 of 8 cases and was normal in all 4 cases; 2 done as emergencies and 2 non-emergencies. Two ergonovine tests were negative. Left ventricular wall motion abnormalities, present mainly at the apex of the left ventricle, returned to normal in 1 to 4 weeks. Giant negative T waves in the chest leads during this recovery period were characteristic electrocardiographic features and normalized in 6 weeks on average. We believe that these episodes were not related to ischemia due to coronary artery disease, but to some metabolic humoral factors. An excellent prognosis can be expected if these abnormal metabolic circumstances can be resolved.
报告了8例被认为与冠状动脉病变无关的左心室短暂可逆性节段性运动失调病例。3例与不明原因的炎症反应有关，1例分别与乳酸酸中毒、腹部手术、低血糖、破伤风和肺炎有关。这些发作之前或之后，所有患者均无提示缺血性心脏病的症状。这些发作之前的心电图均正常。进行二维超声心动图以评估异常心电图。8例中的4例进行了冠状动脉造影，所有4例均正常；2例为急诊，2例为非急诊。两次麦角新碱试验均为阴性。主要出现在左心室心尖部的左心室壁运动异常在1至4周内恢复正常。在此恢复期间，胸导联巨大负向T波是特征性心电图表现，平均6周恢复正常。我们认为，这些发作与冠状动脉疾病导致的缺血无关，而是与某些代谢性体液因素有关。如果这些异常代谢情况能够得到解决，可以预期预后良好。
