Takarada A, Kurogane H, Fujino M, Imai N, Minamiji K, Yamasaki T, Shite J, Yoshida Y, Yokota Y, Fukuzaki H
Himeji Cardiovascular Center.
J Cardiol. 1989 Sep;19(3):717-27.
To evaluate the effects of early recanalization on left and right ventricular wall motion in acute myocardial infarction (AMI), we serially observed their degrees in 66 patients with AMI. The patients were categorized as Group 1:17 with spontaneous recanalization within 6 hours of onset of the chest pain; Group 2:34 with effective recanalization within 6 hours (10 by PTCR, 10 by PTCR+ PTCA, and 14 by direct PTCA), and Group 3:21 without effective recanalization. The Group 2 patients were classified in 3 subgroups according to the time intervals from onset of symptoms to recanalization; 11 patients with recanalization within 2 hours (Group 2a), 10 between 2 and 4 hours (Group 2b), and 13 between 4 and 6 hours (Group 2c). The left and right ventricular wall motion abnormality indexes (WMAI) were defined as the means of point scores for the degrees of regional wall motion abnormality at 11 segments of the left ventricle and seven segments of the right ventricle on serial two-dimensional echocardiograms. Results were as follows: 1. The LV-WMAI of Group 1 was smaller on day 1, and improved on day 28 as compared to those of the other groups (0.63 +/- 0.35 to 0.18 +/- 0.18, p less than 0.001). 2. The improvements of the LV-WMAI from days 1 to 28 in Group 2a (WMAI: 1.01 +/- 0.57 to 0.26 +/- 0.26, delta WMAI: 82 +/- 14%) and Group 2b (1.03 +/- 0.38 to 0.52 +/- 0.48, 54 +/- 36%) were greater than that in Group 2c (1.01 +/- 0.46 to 0.64 +/- 0.52, 38 +/- 47%).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估早期再灌注对急性心肌梗死(AMI)患者左、右心室壁运动的影响,我们对66例AMI患者的左、右心室壁运动程度进行了连续观察。患者分为三组:第1组17例,胸痛发作6小时内自发再灌注;第2组34例,6小时内有效再灌注(10例行PTCR,10例行PTCR + PTCA,14例行直接PTCA);第3组21例,无有效再灌注。第2组患者根据症状发作至再灌注的时间间隔分为3个亚组:2小时内再灌注11例(第2a组),2至4小时再灌注10例(第2b组),4至6小时再灌注13例(第2c组)。左、右心室壁运动异常指数(WMAI)定义为系列二维超声心动图上左心室11个节段和右心室7个节段的室壁运动异常程度的评分均值。结果如下:1. 第1组第1天的左心室WMAI较其他组小,且在第28天有所改善(从0.63±0.35降至0.18±0.18,p<0.001)。2. 第2a组(WMAI:1.01±0.57至0.26±0.26,WMAI变化:82±14%)和第2b组(1.03±0.38至0.52±0.48,54±36%)从第1天到第28天左心室WMAI的改善大于第2c组(1.01±0.46至0.64±0.52,38±47%)。(摘要截于250词)