Koito H, Kurimoto T, Sugiura T, Kimura Y, Iwasaka T, Inada M, Shiraishi T, Kobayashi A
Second Department of Internal Medicine, Kansai Medical University, Moriguchi.
J Cardiol. 1987 Mar;17(1):13-20.
To assess right ventricular function in patients with chronic right ventricular infarction, Tc-99m angiocardiography was performed in 64 patients one to three months after the onset of myocardial infarction. These patients were categorized into four groups according to their hemodynamic data in the acute stage using the Forrester classification: 39 patients in group I, 15 in group II, eight in group III and two in group IV. Mean right atrial pressure was nearly equal to or greater than diastolic pulmonary arterial pressure in all patients in group III. We calculated right ventricular ejection fraction (RVEF) and the right ventricular end-diastolic volume index (RVEDVI) as the parameter of right ventricular function, and assessed right ventricular wall motion using the right ventricular regional ejection fraction images (RVREFI). 1. RVEF in group III (25 +/- 3%) was significantly lower than those in groups I, II and IV (44 +/- 6%, 45 +/- 7% and 37 +/- 4%, respectively), and RVEF of all patients in group III was less than 30%. 2. RVEDVI in group III (150 +/- 25 ml/m2) was significantly greater than those in groups I, II and IV (74 +/- 20 ml/m2, 59 +/- 14 ml/m2 and 91 +/- 36 ml/m2, respectively). 3. RVREFI in group III decreased at the inferior and/or septal regions of the right ventricle, indicating wall motion abnormalities at the corresponding sites. 4. Six patients in group III were examined by coronary angiography and all had definite lesions in the proximal portion of the right coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估慢性右心室梗死患者的右心室功能，对64例心肌梗死后1至3个月的患者进行了锝-99m心血管造影。根据急性期的血流动力学数据，采用福雷斯特分类法将这些患者分为四组：I组39例，II组15例，III组8例，IV组2例。III组所有患者的平均右心房压力几乎等于或高于舒张期肺动脉压力。我们计算了右心室射血分数（RVEF）和右心室舒张末期容积指数（RVEDVI）作为右心室功能参数，并使用右心室局部射血分数图像（RVREFI）评估右心室壁运动。1. III组的RVEF（25±3%）显著低于I组、II组和IV组（分别为44±6%、45±7%和37±4%），且III组所有患者的RVEF均小于30%。2. III组的RVEDVI（150±25 ml/m²）显著高于I组、II组和IV组（分别为74±20 ml/m²、59±14 ml/m²和91±36 ml/m²）。3. III组的RVREFI在右心室下壁和/或间隔区域降低，表明相应部位存在壁运动异常。4. 对III组的6例患者进行了冠状动脉造影检查，所有患者右冠状动脉近端均有明确病变。（摘要截短于250字）
