Stoupel E, Shimshoni M, Agmon J
Toor Heart Institute, Beilinson Medical Center, Petah Tikva, Israel.
Clin Cardiol. 1988 Jan;11(1):45-9. doi: 10.1002/clc.4960110116.
A total of 1744 patients admitted to the ICCU with acute myocardial infarction (AMI) were studied in 1462 consecutive days (1982-1986). The aim of the study was to check whether the localization of the AMI was time related. Anterior (anterolateral) (AW) (n = 834) versus inferior-posterior (inferolateral) (IPW) (n = 823) AMI were compared: a third group with isolated lateral wall (LW) AMI (n = 87) was included in the study. Significant differences between monthly AMI localizations were registered, but no rhythmicity (monthly, seasonal) was found. A small absolute prevalence of AW localizations was found in all four seasons, but monthly differences made those differences not statistically significant. Some significant correlation (p less than 0.01) was found between AW AMI domination and daily geomagnetic activity (GMA level I-IV). Only on days with low (quiet) levels of GMA were there more IPW AMIs. Adverse relationship was seen with LW AMI, relatively benign in AMI, was adversely correlated with GMA level (p less than 0.01). Differences in AW/IPW and left/right coronary artery autonomic receptors distribution and flow regulation and/or changes in cardiovascular homeostasis/coagulation, aggregation, viscosity, microcirculation, and so on connected with AMI expansion may be involved in these differences of AMI localization.
在1982年至1986年连续的1462天里,对1744名入住重症冠心病监护病房(ICCU)的急性心肌梗死(AMI)患者进行了研究。该研究的目的是检查AMI的部位是否与时间有关。比较了前壁(前侧壁)(AW)(n = 834)与下后壁(下侧壁)(IPW)(n = 823)AMI:研究中纳入了第三组孤立性侧壁(LW)AMI患者(n = 87)。记录到每月AMI部位之间存在显著差异,但未发现节律性(每月、季节性)。在所有四个季节中均发现AW部位的绝对患病率较低,但每月的差异使这些差异无统计学意义。在AW AMI占主导与每日地磁活动(GMA I-IV级)之间发现了一些显著相关性(p<0.01)。仅在GMA水平较低(平静)的日子里,IPW AMI更多。LW AMI存在不利关系,LW AMI在AMI中相对良性,与GMA水平呈负相关(p<0.01)。AW/IPW以及左/右冠状动脉自主神经受体分布和血流调节的差异和/或与AMI扩展相关的心血管内环境稳定/凝血、聚集、粘度、微循环等变化可能与AMI部位的这些差异有关。