Andersen Niels Holmark, Karlsen Finn Michael, Gerdes Jens Christian, Kaltoft Anne, Sloth Erik, Thuesen Leif, Bøtker Hans Erik, Poulsen Steen Hvitfeldt
Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark.
J Am Soc Echocardiogr. 2007 Jun;20(6):724-30. doi: 10.1016/j.echo.2006.11.012.
We sought to evaluate the effect of acute coronary thrombectomy, as adjunctive treatment to primary percutaneous coronary intervention, on the systolic and diastolic left ventricular function, in patients with acute S-T elevation myocardial infarction.
In a prospective randomized study, patients with acute S-T elevation myocardial infarction were randomized to treatment with primary percutaneous coronary intervention with or without thrombectomy. Outcome measures were left ventricular volumes and ejection fraction in addition to systolic long-axis function, estimated from the tissue Doppler systolic velocities of the mitral ring. Diastolic function was assessed by mitral inflow and diastolic velocities of the mitral ring movement.
Of the 215 patients included, 172 patients (80%) had a 30-day follow-up. There were no significant differences in ejection fraction between groups during follow-up (thrombectomy at baseline 47 +/- 14% vs 47 +/- 14% at follow-up, control group at baseline 48 +/- 11% vs 51 +/- 12% at follow-up, P = not significant). Systolic velocities were significantly higher in the control group at follow-up (thrombectomy, at baseline, 6.5 +/- 1.9 vs 6.3 +/- 1.8 cm/s at follow-up; control group, at baseline, 6.5 +/- 1.9 vs 7.0 +/- 1.9 cm/s at follow-up; P < .05). There were no significant differences in diastolic function between the two groups.
Thrombectomy had no beneficial effect on the left ventricular function in patients with acute S-T elevation myocardial infarction.
我们试图评估急性冠状动脉血栓切除术作为直接经皮冠状动脉介入治疗的辅助治疗，对急性ST段抬高型心肌梗死患者左心室收缩和舒张功能的影响。
在一项前瞻性随机研究中，急性ST段抬高型心肌梗死患者被随机分为接受或不接受血栓切除术的直接经皮冠状动脉介入治疗组。除了根据二尖瓣环组织多普勒收缩速度估计的收缩期长轴功能外，观察指标还包括左心室容积和射血分数。通过二尖瓣血流和二尖瓣环运动的舒张速度评估舒张功能。
纳入的215例患者中，172例（80%）进行了30天随访。随访期间两组射血分数无显著差异（血栓切除术组基线时为47±14%，随访时为47±14%；对照组基线时为48±11%，随访时为51±12%，P值无统计学意义）。随访时对照组的收缩速度显著更高（血栓切除术组基线时为6.5±1.9，随访时为6.3±1.8 cm/s；对照组基线时为6.5±1.9，随访时为7.0±1.9 cm/s；P<0.05）。两组舒张功能无显著差异。
血栓切除术对急性ST段抬高型心肌梗死患者的左心室功能无有益影响。
