Buda A J, Dubbin J D, Meindok H
Am Heart J. 1986 Jan;111(1):36-41. doi: 10.1016/0002-8703(86)90550-8.
To determine changes in global and regional left ventricular function following acute myocardial function, 17 patients underwent radionuclide angiography at 3 and 10 days post infarction. Five patients had nontransmural myocardial infarction and 12 had transmural infarction (six anterior and six inferior). There were no previous infarctions in 16 (94%) patients. Regional ejection fractions were calculated by dividing the left ventricle into four quadrants using the geometric center of the left ventricle on the end-diastolic frame as a reference point. At 3 days post infarction, 8 of 17 (47%) patients had an abnormality of global left ventricular ejection fraction (LVEF), whereas 16 of 17 (94%) patients had abnormalities of one or more regional ejection fractions (p less than 0.01). Between 3 and 10 days, global LVEF did not change (51% to 49%, p = NS). However, there were significant changes in 23 of 68 (34%) regional LVEFs. These changes did not relate to type, ECG location, creatine kinase (CK) size of infarction, or initial global LVEF. These data suggest that regional LVEF is a sensitive technique for identifying segmental dysfunction associated with myocardial infarction. In addition, significant changes occur in regional LV function during acute myocardial infarction despite stable serial global LV performance.
为了确定急性心肌梗死后左心室整体和局部功能的变化，17例患者在梗死后3天和10天接受了放射性核素血管造影检查。5例患者为非透壁性心肌梗死，12例为透壁性梗死（6例前壁梗死和6例下壁梗死）。16例（94%）患者既往无梗死病史。通过以舒张末期图像上左心室的几何中心为参考点，将左心室分为四个象限来计算局部射血分数。梗死后3天，17例患者中有8例（47%）左心室整体射血分数（LVEF）异常，而17例患者中有16例（94%）一个或多个局部射血分数异常（p<0.01）。在3天至10天之间，整体LVEF没有变化（51%至49%，p=无显著性差异）。然而，68个局部LVEF中有23个（34%）发生了显著变化。这些变化与梗死类型、心电图定位、肌酸激酶（CK）梗死面积或初始整体LVEF无关。这些数据表明，局部LVEF是识别与心肌梗死相关的节段性功能障碍的敏感技术。此外，尽管连续的整体左心室功能稳定，但在急性心肌梗死期间局部左心室功能仍会发生显著变化。
