Shen W F, Cui L Q, Wang M H, Gong L S, Lesbre J P
Department of Cardiology, Rui Jin Hospital, Shanghai Second Medical University.
Chin Med J (Engl). 1990 Dec;103(12):1015-8.
For assessing the relationship between the left ventricular (LV) wall motion abnormalities and the status of residual flow to the infarcted region, the extent of coronary artery disease and one-year outcome, 60 patients with a first transmural, Q-wave myocardial infarction (MI) underwent serial echocardiographic examinations. The abnormal wall motion (AWM) score was calculated, and the cardiac events (death, reinfarction, severe ventricular arrhythmia or congestive heart failure) after discharge were recorded. The AWM score of the infarcted area was higher in patients with total occlusion than in those with subtotal occlusion (anterior MI: 14.6 +/- 2.4 vs 7.2 +/- 2.1; inferior MI: 9.7 +/- 2.1 vs 5.1 +/-1.2, all P less than 0.01). Regional wall motion of the noninfarcted area was preserved in patients with single vessel disease but decreased in those with multivessel disease. In patients who developed cardiac events in follow-up period a higher AWM (16.4 +/- 3.7) was found than in those who did not (8.9 +/- 3.1, P less than 0.05). A score of greater than 13 had a strong prediction of cardiac events after acute MI, with a sensitivity of 81%, specificity of 94% and positive predictive accuracy of 88%.
为评估左心室（LV）壁运动异常与梗死区域残余血流状态、冠状动脉疾病程度及一年预后之间的关系，对60例首次发生透壁性Q波心肌梗死（MI）的患者进行了系列超声心动图检查。计算异常壁运动（AWM）评分，并记录出院后的心脏事件（死亡、再梗死、严重室性心律失常或充血性心力衰竭）。完全闭塞患者梗死区域的AWM评分高于次全闭塞患者（前壁心肌梗死：14.6±2.4对7.2±2.1；下壁心肌梗死：9.7±2.1对5.1±1.2，均P＜0.01）。单支血管病变患者非梗死区域的局部壁运动得以保留，但多支血管病变患者的局部壁运动则降低。在随访期间发生心脏事件的患者中，AWM评分（16.4±3.7）高于未发生心脏事件的患者（8.9±3.1，P＜0.05）。评分大于13对急性心肌梗死后的心脏事件具有较强的预测能力，敏感性为81%，特异性为94%，阳性预测准确率为88%。
