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人类心肌梗死愈合后的右心室功能。心血管造影评估。

Right ventricular function in healed myocardial infarction in man. A cineangiographic assessment.

作者信息

Boschat J, Etienne Y, Bellet M, Barra J, Blanc J J, Penther P

出版信息

Eur J Radiol. 1985 Feb;5(1):17-23.

PMID:4006947
Abstract

To evaluate the frequency of right ventricular dysfunction following recovery from myocardial infarction (MI) and the relationship of segmental right ventricular (RV) wall motion abnormalities to left ventricular (LV) function or location of coronary arterial stenosis, biplane right and left ventricular cineangiograms were obtained in 100 consecutive patients (4 +/- 3 months post MI). Thirty (group A) had anterior MI and significant stenosis or obstruction of left anterior descending artery (LAD). The remaining 70 patients had inferior MI. They were divided into three groups according to the site of the main coronary stenosis or obstruction and corresponding LV akinesia: right coronary artery (RCA) proximal to the acute marginal artery (RMA), (group B: 32 patients), RCA distal to the RMA (group C: 18 patients), left circumflex artery (LCF), (group D: 18 patients). RV and LV end-diastolic volume index (EDV), end-systolic volume index (ESV), stroke volume (SV) and ejection fraction (EF) have been determined. RV segmental wall motion was assessed in RAO and LAO projection by determining the percentage of systolic shortening (+ delta R) along 11 hemiaxes. Mean axial shortening (delta R) of the RV inferior and free walls were considered. When compared with that in 10 normal subjects, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV) were increased and RV ejection fraction (RVEF) was lower in patients with anterior or inferior MI. Inferior delta R exhibited comparable sequential changes in the three groups of inferior MI and similar LVEF alteration.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估心肌梗死(MI)恢复后右心室功能障碍的发生率,以及右心室(RV)节段性室壁运动异常与左心室(LV)功能或冠状动脉狭窄部位的关系,对100例连续的患者(心肌梗死后4±3个月)进行了双平面右心室和左心室电影血管造影检查。30例(A组)为前壁心肌梗死且左前降支(LAD)存在明显狭窄或阻塞。其余70例患者为下壁心肌梗死。根据主要冠状动脉狭窄或阻塞部位及相应的左心室运动减弱情况将他们分为三组:急性边缘动脉(RMA)近端的右冠状动脉(RCA)(B组:32例患者)、RMA远端的RCA(C组:18例患者)、左旋支动脉(LCF)(D组:18例患者)。测定了右心室和左心室的舒张末期容积指数(EDV)、收缩末期容积指数(ESV)、每搏量(SV)和射血分数(EF)。通过测定沿11个半轴的收缩期缩短百分比(+ΔR),在右前斜位(RAO)和左前斜位(LAO)投影中评估右心室节段性室壁运动。考虑右心室下壁和游离壁的平均轴向缩短(ΔR)。与10例正常受试者相比,前壁或下壁心肌梗死患者的右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)增加,右心室射血分数(RVEF)降低。下壁ΔR在三组下壁心肌梗死患者中呈现出类似的连续变化,左心室射血分数(LVEF)改变也相似。(摘要截取自250字)

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