Armstrong W F
Indiana University School of Medicine and Research Associate, Krannert Institute of Cardiology, Indianapolis 46202.
Int J Card Imaging. 1987;2(4):241-58. doi: 10.1007/BF01784780.
Echocardiographic techniques are becoming more widespread for evaluating patients with known or suspected coronary artery disease. Because it affords an excellent overall view of the heart, two-dimensional echocardiography, rather than M-mode echocardiography, is the imaging procedure of choice when dealing with coronary artery disease. This technique can be used to make the initial diagnosis of acute myocardial infarction, diagnose complications, and assess prognosis following myocardial infarction. Additionally by combining this test with stress testing, latent coronary artery disease can be detected. Recovery of wall motion can be assessed following interventions such as thrombolysis or balloon angioplasty. Investigational and future uses include tissue characterization, which may allow detection of ischemic but potentially viable myocardium, direct coronary visualization for detection of atherosclerotic involvement of the proximal coronary arteries and myocardial contrast echocardiography. The latter technique allows visualization of perfusion by way of injecting contrast material into the coronary circulation. This has been demonstrated to be an accurate means of determining myocardial infarction size in an animal model and is currently being used in a number of centers in patients at the time of cardiac catheterization. In summary two-dimensional echocardiography currently allows assessment of patients with myocardial infarction from the time of their presentation through their convalescent period with respect to diagnosis, prognosis and presence of complications. Exercise echocardiography can diagnose latent coronary artery disease. The newer investigational techniques show promise for furthering our ability to evaluate patients with coronary artery disease using echocardiography.
超声心动图技术在评估已知或疑似冠心病患者方面正变得越来越普遍。由于二维超声心动图能提供心脏的极佳整体视图，而非M型超声心动图，所以在处理冠心病时，它是首选的成像检查方法。该技术可用于急性心肌梗死的初步诊断、并发症的诊断以及心肌梗死后的预后评估。此外，通过将此项检查与负荷试验相结合，可检测隐匿性冠心病。在进行溶栓或球囊血管成形术等干预后，可评估室壁运动的恢复情况。研究性及未来的应用包括组织特性分析，这可能有助于检测缺血但仍具潜在存活能力的心肌、直接冠状动脉显影以检测近端冠状动脉的动脉粥样硬化累及情况以及心肌对比超声心动图。后一种技术通过向冠状动脉循环中注射造影剂来实现灌注显影。在动物模型中，这已被证明是确定心肌梗死面积的一种准确方法，目前在一些中心，心脏导管插入术时已将其应用于患者。总之，二维超声心动图目前能够在患者从发病到康复的整个过程中，就诊断、预后和并发症情况对心肌梗死患者进行评估。运动超声心动图可诊断隐匿性冠心病。更新的研究技术有望进一步提升我们利用超声心动图评估冠心病患者的能力。
