Sugiura T, Iwasaka T, Yuasa F, Matsutani M, Tarumi N, Inada M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Chest. 1991 Jul;100(1):128-30. doi: 10.1378/chest.100.1.128.
To elucidate the clinical characteristics associated with regional ventricular dilatation in the early phase of myocardial infarction (MI), 228 patients with acute Q-wave anterior MI were studied. Forty-nine patients (21 percent) had echocardiographically demonstrated regional ventricular dilatation (an abnormal bulge in the left ventricular contour during both systole and diastole) on the third hospital day. Careful auscultation revealed that a pericardial rub was present in 49 patients (21 patients with and 28 patients without regional ventricular dilatation) during the first three days after hospital admission. Multivariate analysis was performed to determine the relative importance of pericardial rub with six other clinical variables related to regional ventricular dilatation. Pericardial rub and cardiac output were the significant factors related to the presence of regional ventricular dilatation. Thus, a pericardial rub, in concert with impaired left ventricular function, is a physical sign associated with regional ventricular dilatation, and anatomically transmural infarction is the possible factor explaining their association.
为了阐明心肌梗死（MI）早期与局部心室扩张相关的临床特征，对228例急性Q波前壁MI患者进行了研究。49例患者（21%）在入院第三天经超声心动图显示有局部心室扩张（收缩期和舒张期左心室轮廓均有异常膨出）。仔细听诊发现，49例患者（21例有局部心室扩张，28例无局部心室扩张）在入院后的头三天出现心包摩擦音。进行多变量分析以确定心包摩擦音与其他六个与局部心室扩张相关的临床变量的相对重要性。心包摩擦音和心输出量是与局部心室扩张存在相关的重要因素。因此，心包摩擦音与左心室功能受损共同作用，是与局部心室扩张相关的体征，而解剖学上的透壁梗死可能是解释它们之间关联的因素。
