Tomaru T, Mori W
Second Department of Internal Medicine, University of Tokyo.
Jpn Heart J. 1988 Jan;29(1):79-88. doi: 10.1536/ihj.29.79.
To evaluate pathologic features of myocardial infarction of the right ventricle (MI-RV), we analyzed 106 autopsy cases with transmural myocardial infarction (MI) (fresh in 46 cases and healed in 60). Anterior MI was observed in 47, posterior MI in 54 and lateral in 5. There were 13 cases (12%) with MI-RV (anterior in 1 case and posterior in 12), which included 10 cases with fresh MI and 3 with healed MI. All cases with MI-RV had associated transmural interventricular septal infarction. Of the 13 cases with MI-RV, 9 (69%) had right ventricular dilatation (RVD) and 2 had right ventricular hypertrophy. Extensive MI-RV (more than 1/3 of the right ventricle) was observed in 8 (89%) of those with RVD. Of 93 cases of MI without MI-RV, 14 (16%) had RVD. The incidence of RVD was greater in cases with MI-RV than in those without (p less than 0.005). All 12 cases with posterior MI-RV had significant (greater than or equal to 75%) narrowing of the right coronary artery (RCA), and 19 cases (87%) of those with posterior MI without MI-RV, had similar lesions. In conclusion, the incidence of RVD and significant narrowing of RCA was greater in cases with posterior MI-RV than in those with posterior MI.
为评估右心室心肌梗死（MI-RV）的病理特征，我们分析了106例透壁性心肌梗死（MI）的尸检病例（46例为新鲜梗死，60例为陈旧性梗死）。前壁MI 47例，后壁MI 54例，侧壁MI 5例。有13例（12%）发生MI-RV（前壁1例，后壁12例），其中包括10例新鲜MI和3例陈旧性MI。所有MI-RV病例均伴有透壁性室间隔梗死。在13例MI-RV病例中，9例（69%）有右心室扩张（RVD），2例有右心室肥厚。在有RVD的患者中，8例（89%）观察到广泛的MI-RV（超过右心室的1/3）。在93例无MI-RV的MI病例中，14例（16%）有RVD。MI-RV患者的RVD发生率高于无MI-RV患者（p<0.005）。所有12例后壁MI-RV患者的右冠状动脉（RCA）均有明显狭窄（≥75%），在19例（87%）无MI-RV的后壁MI患者中也有类似病变。总之，后壁MI-RV患者的RVD发生率和RCA明显狭窄的发生率高于后壁MI患者。
