通过血清肌酸激酶活性和胸前心电图标测预测急性前壁心肌梗死患者的左心室功能

Prediction of left ventricular function in acute anterior myocardial infarction by serum creatine kinase activity and precordial ECG mapping.

作者信息

Marchionni N, Moschi G, Lombardi A, Tozzi P, Salani B, Di Bari M, Ferrucci L, Paoletti M

出版信息

Clin Cardiol. 1986 May;9(5):187-90. doi: 10.1002/clc.4960090504.

Abstract

Right cardiac catheterization, serial determination of creatine phosphokinase (CPK) and of CPK-MB activities, and precordial 35-lead ECG mapping were performed in 17 consecutive patients with a first anterior acute myocardial infarction (AMI) within 6 hours of the onset of symptoms. Left ventricular function as determined by the stroke index (SI, ml/m2) to mean pulmonary capillary wedge pressure (PCWP, mmHg) ratio inversely correlated either with the total CPK and CPK-MB released and with peak enzymatic activity, or with the entity of early (6th hour ECG) ST-segment elevation. Conversely, a direct correlation was found between the SI/PCWP ratio and the ratio of R to Q+S waves from late (48th hour) ECG. Residual left ventricular function after a first anterior AMI can therefore be estimated noninvasively in the individual patient by early precordial ECG mapping and by peak enzymatic activity.

摘要

对17例症状发作6小时内首次发生前壁急性心肌梗死（AMI）的连续患者进行了右心导管检查、肌酸磷酸激酶（CPK）及CPK-MB活性的系列测定，以及胸前35导联心电图标测。通过每搏指数（SI，ml/m²）与平均肺毛细血管楔压（PCWP，mmHg）的比值所确定的左心室功能，与释放的总CPK和CPK-MB以及酶活性峰值呈负相关，或与早期（第6小时心电图）ST段抬高程度呈负相关。相反，在SI/PCWP比值与晚期（第48小时）心电图R波与Q+S波的比值之间发现了直接相关性。因此，对于首次前壁AMI后的个体患者，可通过早期胸前心电图标测和酶活性峰值对残余左心室功能进行无创评估。