Wiener I, Meller J, Packer M, Herman M V, Teichholz L E
Am Heart J. 1979 Jun;97(6):726-32. doi: 10.1016/0002-8703(79)90007-3.
To determine the clinical usefulness of echocardiography in patients with anteroseptal myocardial infarction, echocardiograms were performed within 24 hours of admission on 40 patients with acute transmural anteroseptal myocardial infarction. Twenty-one patients had normal septal motion and septal systolic thickening, and 19 patients had abnormalities of one or both of these measurements. Of the 21 patients who had normal septal motion and thickening, only five developed congestive heart failure, none developed bundle branch block, and none died. Of the 19 patients with abnormal septal motion and/or thickening, 17 developed congestive heart failure (p less than .001), seven developed bundle branch block (p less than .001), and six died (p less than .001). Therefore, (1) electrocardiographic evidence of septal infarction does not correlate with abnormalities of the portion of septum seen on echocardiogram, and (2) patients with anteroseptal myocardial infarction and abnormalities of the septum on echocardiogram have more complications and a higher in-hospital mortality rate. These patients may have more extensive myocardial infarction predisposing to pump failure and possibly involving the conduction system.
为了确定超声心动图在急性前间隔心肌梗死患者中的临床应用价值，对40例急性透壁性前间隔心肌梗死患者在入院后24小时内进行了超声心动图检查。21例患者的室间隔运动和室间隔收缩期增厚正常，19例患者的这两项测量中有一项或两项异常。在室间隔运动和增厚正常的21例患者中，只有5例发生充血性心力衰竭，无一例发生束支传导阻滞，也无死亡病例。在室间隔运动和/或增厚异常的19例患者中，17例发生充血性心力衰竭（p<0.001），7例发生束支传导阻滞（p<0.001），6例死亡（p<0.001）。因此，（1）室间隔梗死的心电图证据与超声心动图所见室间隔部分的异常不相关，（2）前间隔心肌梗死且超声心动图示室间隔异常的患者有更多并发症和更高的院内死亡率。这些患者可能有更广泛的心肌梗死，易发生泵衰竭，并可能累及传导系统。
