Matsumura R
First Department of Surgery, Osaka University Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Oct;38(10):2068-75.
In order to determine the effects of coronary revascularization for infarcted regions on postoperative left ventricular function and regional wall motion, we studied first-pass radionuclide angiography at rest and during exercise before and after operation in 18 patients with previous myocardial infarction. Preoperative mean value of left ventricular ejection fraction (LVEF) was significantly decreased during exercise from 56.8 +/- 14.1% to 46.1 +/- 15.5% (p less than 0.01). Postoperatively, there was no change of the values between at rest and during exercise: 53.6 +/- 14.1% versus 51.9 +/- 15.7%. Postoperative mean LVEF during exercise was significantly higher, compared with that of preoperative LVEF (p less than 0.05). Mean regional ejection fraction of infarcted regions was significantly decreased during exercise from 66.0 +/- 15.0% to 56.1 +/- 15.8% (p less than 0.01) before operation. However, there was no significant change in values between at rest and during exercise after operation: 65.4 +/- 13.9% versus 61.8 +/- 14.5%. Mean postoperative regional ejection fraction during exercise was significantly higher, compared with preoperative regional ejection fraction after operation (p less than 0.05). These results might be indicated that regional wall motion of the infarcted regions with ischemia enhanced by exercise preoperatively can be definitely improved by coronary revascularization.
为了确定梗死区域的冠状动脉血运重建对术后左心室功能和局部室壁运动的影响，我们对18例既往有心肌梗死的患者在手术前后静息及运动状态下进行了首次通过放射性核素血管造影研究。术前左心室射血分数（LVEF）的平均值在运动时从56.8±14.1%显著降至46.1±15.5%（p<0.01）。术后，静息和运动时的值无变化：分别为53.6±14.1%和51.9±15.7%。与术前运动时的LVEF相比，术后运动时的平均LVEF显著更高（p<0.05）。术前运动时梗死区域的平均局部射血分数从66.0±15.0%显著降至56.1±15.8%（p<0.01）。然而，术后静息和运动时的值无显著变化：分别为65.4±13.9%和61.8±14.5%。与术后术前局部射血分数相比，术后运动时的平均局部射血分数显著更高（p<0.05）。这些结果可能表明，术前运动增强的梗死区域缺血性局部室壁运动可通过冠状动脉血运重建得到明确改善。
