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[心肌梗死后肌肉运动时的血流动力学数据。与冠状动脉造影及心室造影数据的相关性]

[Hemodynamic data during muscular exercise after myocardial infarction. Correlations with coronaro-ventriculographic data].

作者信息

Ferrini M, Tartulier M, Milan J J, Boutarin J, Ritz B, Deyrieux F, Blum J

出版信息

Arch Mal Coeur Vaiss. 1984 Apr;77(4):405-12.

PMID:6426427
Abstract

Forty six patients aged 25 to 67 years (average : 52 years) underwent measurement of pulmonary arterial pressure (PAP), systemic pressure and cardiac output (Fick) at rest and during exercise in the recumbent position 12 +/- 3 weeks after uncomplicated myocardial infarction; the results were then compared with those of coronary angiography and right anterior oblique monoplane left ventriculography. The site of infarction was anterior in 18 cases and postero-diaphragmatic in 28 cases; it was non-transmural in 4 cases. Twenty patients (43%) had multivessel disease; this was equally common in anterior and inferior wall infarction. Regional wall abnormalities of 3 or more segments were observed in 14 cases. Mean PAP increased from 12,3 +/- 4,6 Torr at rest to 27,8 +/- 10,5 Torr on exercise. In 17 patients (Group A) PAP was normal at rest and during exercise (10 +/- 2 Torr and 18 +/- 3 Torr respectively); 25 patients (Group B) had normal resting PAP (12 +/- 3 Torr) but an abnormal rise on exercise (32 +/- 8 Torr); in 4 patients (Group C) PAP was abnormal at rest (24 +/- 4 Torr) and on exercise (44 +/- 7 Torr). The increase in PAP on exercise was inversely correlated to the ejection fraction (p less than 0.001) and related to the extent of left ventricular hypokinesia (p less than 0.001). Patients in Group A had higher ejection fractions (p less than 0.05), dp/dt/p index (p less than 0.01) and left ventricular compliance (p less than 0.01), lower resting (p less than 0.01) and exercise (p less than 0.05) systemic pressures and small regional wall abnormalities (p less than 0.01) than patients in Group B.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

46例年龄在25至67岁(平均52岁)的患者,在无并发症的心肌梗死后12±3周,于卧位休息及运动时接受了肺动脉压(PAP)、体循环压力及心输出量(Fick法)的测量;然后将结果与冠状动脉造影及右前斜位单平面左心室造影结果进行比较。梗死部位为前壁的有18例,后下壁的有28例;4例为非透壁性梗死。20例患者(43%)有多支血管病变;在前壁和下壁梗死中同样常见。14例观察到3个或更多节段的局部室壁异常。平均肺动脉压从休息时的12.3±4.6 Torr增加到运动时的27.8±10.5 Torr。17例患者(A组)休息及运动时肺动脉压正常(分别为10±2 Torr和18±3 Torr);25例患者(B组)休息时肺动脉压正常(12±3 Torr)但运动时升高异常(32±8 Torr);4例患者(C组)休息时(24±4 Torr)及运动时(44±7 Torr)肺动脉压均异常。运动时肺动脉压的升高与射血分数呈负相关(p<0.001),并与左心室运动减弱的程度相关(p<0.001)。A组患者的射血分数(p<0.05)、dp/dt/p指数(p<0.01)及左心室顺应性(p<0.01)较高,休息时(p<0.01)及运动时(p<0.05)的体循环压力较低,局部室壁异常较小(p<0.01),与B组患者相比。(摘要截短于250字)

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