左前降支冠状动脉终止（包裹或非包裹特性）对前壁心肌梗死患者组织多普勒超声心动图结果的影响：一项观察性研究。

Effect of termination of the left anterior descending coronary artery (wrapped or non-wrapped property) on tissue Doppler echocardiography findings in patients with anterior myocardial infarction: an observational study.

作者信息

Sönmez Osman, Vatankulu Mehmet A, Kayrak Mehmet, Karaarslan Şükrü, Altunbaş Gökhan, Özdemir Kurtuluş, Gök Hasan

机构信息

Department of Cardiology, Faculty of Medicine, University of Bezmi Alem Foundation, İstanbul-Turkey.

出版信息

Anadolu Kardiyol Derg. 2012 Sep;12(6):465-71. doi: 10.5152/akd.2012.152. Epub 2012 Jun 7.

DOI:10.5152/akd.2012.152

PMID:22677404

Abstract

OBJECTIVE

We aimed to evaluate effect of termination property of left anterior descending (LAD) on tissue Doppler echocardiography (TDE) parameters in patients experiencing their first anterior myocardial infarction (AMI) who had undergone successful primary percutaneous coronary intervention (PCI).

METHODS

A prospective, cross-sectional observational study was performed. Eighty-four patients were enrolled in the study. Echocardiography was performed during the first three days of AMI. Conventional TDE measurements were obtained from right ventricular (RV) and four left ventricular (LV) walls: for the systolic function - mitral annular TDE systolic velocity - Sm, for diastolic function - mitral annular TDE early and late diastolic velocities - Em, Am, transmitral early and late diastolic velocities ratio - E/A, and combined systolic and diastolic function - myocardial performance index (MPI). Coronary arteries were evaluated and patients were divided into two groups (non-wrapped LAD and wrapped LAD) according to the termination properties. Student-t, Mann-Whitney U and Chi-square tests, bivariate Pearson and Spearman correlation analyses were used for statistical analysis.

RESULTS

Baseline characteristics and conventional echocardiographic parameters of the patients were similar. There was a statistically significant difference for the anterior wall Sm parameter, whereas there was no substantial difference for Em, Am and MPI values. The anterior wall Sm was more affected in patients with non wrapped LAD than in patients with wrapped LAD (6.70 ± 1.66 and 7.44 ± 1.66 cm/s; p=0.036,).The anterior Sm parameter was uniquely correlated with LAD termination status when compared with other independent parameters (r=0.236, p=0.036).

CONCLUSION

We showed that termination of LAD is important for the anterior wall systolic functions in the early stage of AMI treated successfully.

摘要

目的

我们旨在评估左前降支（LAD）的终止特性对首次发生前壁心肌梗死（AMI）且已成功接受直接经皮冠状动脉介入治疗（PCI）患者的组织多普勒超声心动图（TDE）参数的影响。

方法

进行了一项前瞻性横断面观察性研究。84例患者纳入本研究。在AMI的头三天内进行超声心动图检查。从右心室（RV）和四个左心室（LV）壁获得传统的TDE测量值：用于评估收缩功能——二尖瓣环TDE收缩期速度——Sm，用于评估舒张功能——二尖瓣环TDE舒张早期和晚期速度——Em、Am，二尖瓣舒张早期和晚期速度比值——E/A，以及收缩和舒张功能综合评估——心肌性能指数（MPI）。评估冠状动脉，并根据终止特性将患者分为两组（非包绕LAD和包绕LAD）。采用学生t检验、曼-惠特尼U检验和卡方检验、双变量Pearson和Spearman相关性分析进行统计学分析。

结果

患者的基线特征和传统超声心动图参数相似。前壁Sm参数存在统计学显著差异，而Em、Am和MPI值无显著差异。非包绕LAD患者的前壁Sm受影响程度大于包绕LAD患者（分别为6.70±1.66和7.44±1.66 cm/s；p=0.036）。与其他独立参数相比，前Sm参数与LAD终止状态具有独特的相关性（r=0.236，p=0.036）。