Ribeiro P, Nihoyannopoulos P, Farah S, Moss D W, Westaby S, Oakley C M, Foale R A
Br Heart J. 1985 Aug;54(2):140-4. doi: 10.1136/hrt.54.2.140.
To evaluate the role of ischaemia in the genesis of new septal wall motion abnormalities after coronary artery bypass surgery 45 patients were studied by cross sectional echocardiography before and 8-10 days after operation. Regional left ventricular wall motion was classified as normal, hypokinetic, akinetic, or dyskinetic. Septal wall motion abnormalities were correlated with electrocardiographic Q wave changes and serial serum MB creatine kinase measured before and 4, 7, 21, 48, and 72 hours after operation. Of the 14 patients who developed new septal wall motion abnormalities after operation two developed septal akinesis (both had perioperative infarction) and one new dyskinesis in the previously akinetic septal segment. Of the 11 patients with new septal hypokinesis, eight had normal serial creatine kinase MB values, two had raised values peaking four and seven hours after operation, with a return to normal values at 21 hours indicating transient ischaemia, and one had enzymatic criteria for perioperative infarction. Most new echocardiographic septal wall motion abnormalities after coronary artery bypass grafting are not caused by transient ischaemia, perioperative infarction, or generalised cell necrosis.
为评估缺血在冠状动脉搭桥手术后新的室间隔壁运动异常发生过程中的作用，对45例患者在手术前及术后8 - 10天进行了横断面超声心动图研究。左心室壁区域运动分为正常、运动减弱、运动消失或运动障碍。室间隔壁运动异常与心电图Q波变化以及术前、术后4、7、21、48和72小时测定的系列血清肌酸激酶MB相关。在术后出现新的室间隔壁运动异常的14例患者中，2例出现室间隔运动消失（均有围手术期梗死），1例在先前运动消失的室间隔节段出现新的运动障碍。在11例新出现室间隔运动减弱的患者中，8例肌酸激酶MB系列值正常，2例值升高，分别在术后4小时和7小时达到峰值，21小时恢复正常，提示短暂性缺血，1例有围手术期梗死的酶学标准。冠状动脉搭桥术后大多数新的超声心动图室间隔壁运动异常并非由短暂性缺血、围手术期梗死或全身性细胞坏死引起。
