Masuoka T, Yoshida O, Oka Y, Kajiyama M, Ito Y, Kawagoe T, Nagao H, Tsuchiya T
Department of Internal Medicine, Akanekai Tsuchiya General Hospital, Hiroshima.
J Cardiol. 1989 Jun;19(2):403-12.
The effect of early myocardial reperfusion (within six hours after the onset of symptoms) on left ventricular (LV) function in 106 patients with acute myocardial infarction was studied. The subjects consisting of 26 with conventional therapy, 19 with percutaneous transluminal coronary recanalization (PTCR), 16 with percutaneous transluminal coronary angioplasty (PTCA) after PTCR, 32 with direct-PTCA and 13 with coronary artery bypass graft (CABG) were randomly observed after 1981. In these patients, left ventricular ejection fraction (LVEF), regional wall motion, end-diastolic pressure and the contractility index were measured as the indices of LV function. 1. Compared to the conventional therapy group, LVEF and regional wall motion improved significantly in all groups with reperfusion therapy except in the PTCR group. This LV function in patients with subtotal obstruction or good initial collaterals significantly improved compared to patients with total obstruction and no collateral circulation. Patients with a 75 percent or more residual stenosis after reperfusion therapy had significantly decreased LV function compared to those with residual stenosis of less than 75 percent. These findings support the potential role for reperfusion therapy in patients with acute myocardial infarction.
研究了106例急性心肌梗死患者早期心肌再灌注(症状发作后6小时内)对左心室(LV)功能的影响。1981年后,对26例接受传统治疗、19例接受经皮腔内冠状动脉再通术(PTCR)、16例PTCR后接受经皮腔内冠状动脉成形术(PTCA)、32例接受直接PTCA和13例接受冠状动脉旁路移植术(CABG)的患者进行了随机观察。在这些患者中,测量左心室射血分数(LVEF)、节段性室壁运动、舒张末期压力和收缩性指数作为LV功能指标。1. 与传统治疗组相比,除PTCR组外,所有再灌注治疗组的LVEF和节段性室壁运动均显著改善。与完全阻塞且无侧支循环的患者相比,次全阻塞或初始侧支循环良好的患者的LV功能显著改善。再灌注治疗后残余狭窄达75%或以上的患者与残余狭窄小于75%的患者相比,LV功能显著降低。这些发现支持了再灌注治疗在急性心肌梗死患者中的潜在作用。