Astorri E, Contini G A, Busi M, Gavaruzzi G
Cattedra di Cardiologia, Università di Parma.
Minerva Cardioangiol. 1991 Apr;39(4):119-24.
The aim of the present paper is the study of the changes induced on right ventricular function after myocardial revascularization with aortocoronary bypass graft. Two-three days before and 6 months after operation gated radionuclide ventriculography has been performed in 25 patients with previous myocardial infarction (MI), anterior in 16 patients and inferior in 9. At postoperative examination, right ventricular ejection fraction (EF) was slightly but significantly reduced (p less than 0.01), while peak ejection and filling rates were unchanged. Symmetric parameters of left ventricular function did not show changes at post-operative control, except a clear-cut rise of left ventricular peak filling rate (p less than 0.05). Before operation, in patients with previous anterior MI, left ventricular EF was slightly less and right ventricular EF slightly more than in patients with previous inferior MI; after operation right ventricular EF significantly decreased (p less than 0.01) only in patients with previous anterior MI. No correlation has been demonstrated in pre- postoperative changes of the observed parameters, neither between the two groups of previous MI nor between right and left ventricular cavity. Six months after myocardial revascularization, left ventricular performance, as examined with radionuclide angiography, was practically unchanged except for improvement of diastolic function, while right ventricular performance was moderately impaired, more in patients with previous anterior MI than in those with previous inferior MI.
本文旨在研究主动脉冠状动脉搭桥术心肌血运重建术后右心室功能的变化。对25例既往有心肌梗死(MI)的患者在术前2 - 3天及术后6个月进行了门控放射性核素心室造影,其中16例为前壁心肌梗死,9例为下壁心肌梗死。术后检查发现,右心室射血分数(EF)略有下降但具有统计学意义(p < 0.01),而射血峰值和充盈率未发生变化。左心室功能的对称参数在术后检查中未显示变化,但左心室峰值充盈率明显升高(p < 0.05)。术前,既往有前壁心肌梗死的患者左心室EF略低于既往有下壁心肌梗死的患者,而右心室EF略高于后者;术后仅既往有前壁心肌梗死的患者右心室EF显著下降(p < 0.01)。在观察参数的术前变化中,未发现两组既往心肌梗死患者之间以及左右心室腔之间存在相关性。心肌血运重建术后6个月,放射性核素血管造影检查显示左心室功能除舒张功能改善外基本未变,而右心室功能中度受损,既往有前壁心肌梗死的患者比既往有下壁心肌梗死的患者受损更严重。