Shiraishi I, Onouchi Z, Hayano T, Hamaoka K, Kiyosawa N
Division of Pediatric Medicine, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
Pediatr Cardiol. 1991 Apr;12(2):78-82. doi: 10.1007/BF02238407.
Eight patients with Kawasaki disease who had sustained asymptomatic myocardial infarction 8-15 years ago (mean, 13.1 years) were reexamined by various noninvasive cardiac function tests to assess long-term prognosis. At present, electrocardiograms (ECGs) are normal in six patients. However, all eight patients had a prolonged preejection period (PEP) to left ventricular ejection time (LVET) ratio 30 s after amylnitrate (AN) inhalation. Six patients had perfusion defects by exercise thallium-201 myocardial scintigraphy, and two patients developed ST segment depression in treadmill exercise testing. These patients are symptom-free even though their physical activity has not been restricted. Yet they proved to have serious abnormalities suggesting sequelae of myocardial infarction or existing myocardial ischemia. Judging from the results of noninvasive cardiac function tests and recently performed coronary angiography, five of the eight patients require coronary bypass surgery.
8例曾在8至15年前（平均13.1年）发生无症状性心肌梗死的川崎病患者，通过各种无创心功能检查进行复查，以评估长期预后。目前，6例患者的心电图（ECG）正常。然而，所有8例患者在吸入亚硝酸异戊酯（AN）30秒后，其射血前期（PEP）与左心室射血时间（LVET）的比值均延长。6例患者通过运动铊-201心肌闪烁显像显示灌注缺损，2例患者在平板运动试验中出现ST段压低。这些患者尽管没有限制体力活动，但仍无症状。然而，他们被证明存在严重异常，提示心肌梗死的后遗症或现有的心肌缺血。根据无创心功能检查结果和最近进行的冠状动脉造影，8例患者中有5例需要进行冠状动脉搭桥手术。
