Golikov A P, Riabinin V A, Galankina I E, Manykin I E
Ter Arkh. 1988;60(7):17-20.
Of 61 patients with myocardial infarction (MI), complicated by cardiorrhexis (CR), 72% had heart failure (HF) in the prerupture period. A small MI zone (35.8 +/- 2.6% of the left ventricular area) was marked in 29 cases of instantaneous CR. Coronary arteries (CA) outside the necrotic zone were slightly necrosed (up to 50%). These factors as well as the hyperdynamic syndrome in 75% of the patients with instantaneous CR on the 1st day and a high frequency of left ventricular aneurysms made it possible to associate HF development with myocardial dyskinesia. In prolonged MI there were several HF causes: a large MI zone (47.9 +/- 3.1%), noticeable CA stenosis outside the MI zone. However, early CR development (on the 4th day) and a high frequency of aneurysms (62%) could be indicative of a considerable contribution of dyskinesia to HF development. A variant of prolonged CR combined with dysfunction of the papillary muscles was attended by HF development in 100% of cases in an intermediate value of a MI zone and the CA state. However, dysfunction of the papillary muscles was one of the variants of myocardial dyskinesia. A conclusion was made of an important role played in HF genesis by myocardial dyskinesia binding HF and CR by the single mechanism.
在61例合并心脏破裂（CR）的心肌梗死（MI）患者中，72%在破裂前期出现心力衰竭（HF）。29例瞬间CR患者的梗死区域较小（占左心室面积的35.8±2.6%）。坏死区域外的冠状动脉（CA）有轻度坏死（高达50%）。这些因素以及75%瞬间CR患者在第1天出现的高动力综合征和高频率的左心室室壁瘤，使得心力衰竭的发生与心肌运动障碍相关。在病程较长的心肌梗死中，心力衰竭有多种原因：梗死区域较大（47.9±3.1%），梗死区域外冠状动脉明显狭窄。然而，早期CR的发生（第4天）和高频率的室壁瘤（62%）可能表明运动障碍对心力衰竭发生有相当大的影响。在梗死区域和冠状动脉状态处于中间值的情况下，病程较长的CR合并乳头肌功能障碍的患者中，100%出现心力衰竭。然而，乳头肌功能障碍是心肌运动障碍的一种表现形式。得出结论：心肌运动障碍通过单一机制将心力衰竭和心脏破裂联系起来，在心力衰竭的发生中起重要作用。
