McGhie A I, Willerson J T, Corbett J R
Department of Internal Medicine, (Cardiology Division), University of Texas Southwestern Medical Center, Dallas 75229.
Circulation. 1991 Sep;84(3 Suppl):I167-76.
Prognosis after acute myocardial infarction is determined primarily by left ventricular function and by the extent to which additional coronary obstructions jeopardize viable myocardium. Radionuclide ventriculography is well suited for noninvasive assessments of resting and exercise ventricular function after acute myocardial infarction. The prognostic importance of resting left ventricular function after acute myocardial infarction is well established. Several studies have reported the prognostic utility of submaximal exercise radionuclide ventriculography at the time of hospital discharge. Patients with globally depressed left ventricular function after acute myocardial infarction are at increased risk for cardiac death, while patients with normal resting ventricular function but abnormal function during exercise appear to be at risk for nonfatal ischemic events. The development of gated tomographic techniques and new radiopharmaceuticals will make available more accurate and detailed assessments of ventricular function and combined assessments of function and perfusion. These new developments require further investigation but appear to be promising new techniques with the potential for providing improved assessments of prognosis after acute myocardial infarction.
急性心肌梗死后的预后主要取决于左心室功能，以及其他冠状动脉阻塞危及存活心肌的程度。放射性核素心室造影非常适合对急性心肌梗死后静息和运动时的心室功能进行无创评估。急性心肌梗死后静息左心室功能的预后重要性已得到充分证实。多项研究报告了出院时次极量运动放射性核素心室造影的预后效用。急性心肌梗死后左心室功能整体降低的患者心脏死亡风险增加，而静息心室功能正常但运动时功能异常的患者似乎有发生非致命性缺血事件的风险。门控断层扫描技术和新型放射性药物的发展将使心室功能的评估更加准确和详细，以及功能与灌注的联合评估成为可能。这些新进展需要进一步研究，但似乎是有前景的新技术，有可能改善对急性心肌梗死后预后的评估。
