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单支血管直接经皮冠状动脉介入治疗的年轻心肌梗死患者且心功能保留时的微伏级T波交替现象

Microvolt T-wave alternans in young myocardial infarction patients with preserved cardiac function treated with single-vessel primary percutaneous coronary intervention.

作者信息

Somuncu Mustafa Umut, Erturk Mehmet, Karakurt Huseyin, Demir Ali Riza, Bulut Umit, Kurtar Asli, Akbay Ertan, Akgul Ozgur

机构信息

Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.

出版信息

Arch Med Sci Atheroscler Dis. 2016 Jul 27;1(1):e68-e74. doi: 10.5114/amsad.2016.61494. eCollection 2016.

Abstract

INTRODUCTION

Myocardial infarction continues to be the most important cause of morbidity and mortality, and recently this disease has begun to be seen commonly at young ages. In our study we aimed to assess microvolt T-wave alternans in young patients who had ST segment elevation myocardial infarction with preserved left ventricular function and who underwent single-vessel revascularization.

MATERIAL AND METHODS

We enrolled 108 consecutive patients (age: 39.5 ±4.1) with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention and 43 patients (age: 38.5 ±3.7) with normal coronary angiograms as a control group. The myocardial infarction patients were younger than 45 and had a preserved left ventricular ejection fraction. They were divided into three groups according to the culprit artery. The microvolt T-wave alternans (MTWA) values were calculated an average of 12 months after the primary percutaneous coronary intervention using the modified moving average method.

RESULTS

The MTWA positivity was significantly higher in the STEMI group compared to the controls ( < 0.001). It was also significantly higher in STEMI patients with left anterior descending artery lesions compared to patients with circumflex artery and right coronary artery lesions ( = 0.013). Moreover, the culprit artery was independent predictor of MTWA positivity ( = 0.043).

CONCLUSIONS

In STEMI patients of a young age, MTWA positivity was higher than in healthy individuals, especially when the responsible vessel fed a wider region.

摘要

引言

心肌梗死仍然是发病和死亡的最重要原因,最近这种疾病在年轻人中开始常见。在我们的研究中,我们旨在评估左心室功能保留且接受单支血管血运重建的ST段抬高型心肌梗死年轻患者的微伏级T波交替。

材料与方法

我们连续纳入了108例接受经皮冠状动脉介入治疗的ST段抬高型心肌梗死(STEMI)患者(年龄:39.5±4.1岁),并纳入43例冠状动脉造影正常的患者(年龄:38.5±3.7岁)作为对照组。心肌梗死患者年龄小于45岁且左心室射血分数保留。根据罪犯血管将他们分为三组。使用改良移动平均法在初次经皮冠状动脉介入治疗后平均12个月计算微伏级T波交替(MTWA)值。

结果

STEMI组的MTWA阳性率显著高于对照组(<0.001)。与回旋支动脉和右冠状动脉病变患者相比,左前降支动脉病变的STEMI患者的MTWA阳性率也显著更高(=0.013)。此外,罪犯血管是MTWA阳性的独立预测因素(=0.043)。

结论

在年轻的STEMI患者中,MTWA阳性率高于健康个体,尤其是当责任血管供血区域更广时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32dc/5421539/29bd19150669/AMS-AD-1-28076-g001.jpg

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