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[二维超声心动图对急性心肌梗死患者梗死面积的评估]

[Estimation of the infarct size by two-dimensional echocardiography in cases with acute myocardial infarction].

作者信息

Sakabe Y, Hishida H, Hagiwara K, Sakai Y, Kondo T, Miyagi Y, Nomura M, Mizuno Y

出版信息

J Cardiogr. 1984 Aug;14(2):247-56.

PMID:6533189
Abstract

We evaluated clinically the infarct size in addition to left ventricular end-diastolic and end-systolic volumes (EDV, ESV) and ejection fraction (EF) using two-dimensional echocardiography (2-D) and algorithms based on the modified Simpson's rule. EDV, ESV and EF obtained by 2-D and three algorithms were compared with those obtained by left ventriculography in 23 patients with various heart diseases. Correlation coefficients obtained by our and other two algorithms were 0.88, 0.88 and 0.90, respectively, for EDV and ESV (p less than 0.01), and 0.71, 0.60 and 0.84 for EF (p less than 0.01). Myocardial mass of the region showing asynergy (asynergic size) was calculated by the above-mentioned three methods and compared with peak serum CK values in 14 patients with acute myocardial infarction. The correlation coefficient between both values was 0.76 (p less than 0.01) by our algorithm and it was higher than by other two algorithms (0.37 and 0.70). The time course of changes in asynergic size in acute myocardial infarction was studied by the use of 2-D and our algorithm. Asynergic size was significantly larger on the day of the onset (24.9 +/- 2.9 ml, mean +/- SE) than the third (21.5 +/- 2.7 ml) and seventh day (20.7 +/- 3.0 ml) after the onset (p less than 0.01). These results suggest that one can make a quantitative and serial estimation of infarct size as well as left ventricular volume by 2-D and our modified model, and that our algorithm is suitable for the purpose.

摘要

我们使用二维超声心动图(2-D)以及基于改良辛普森法则的算法,除了评估左心室舒张末期和收缩末期容积(EDV、ESV)以及射血分数(EF)外,还对梗死面积进行了临床评估。在23例患有各种心脏病的患者中,将通过二维超声心动图和三种算法获得的EDV、ESV和EF与通过左心室造影获得的结果进行了比较。我们的算法和其他两种算法获得的EDV和ESV的相关系数分别为0.88、0.88和0.90(p<0.01),EF的相关系数分别为0.71、0.60和0.84(p<0.01)。通过上述三种方法计算出显示运动不协调区域的心肌质量(运动不协调面积),并将其与14例急性心肌梗死患者的血清肌酸激酶峰值进行比较。通过我们的算法,两者之间的相关系数为0.76(p<0.01),高于其他两种算法(0.37和0.70)。利用二维超声心动图和我们的算法研究了急性心肌梗死中运动不协调面积的变化时间过程。发病当天的运动不协调面积(24.9±2.9ml,平均值±标准误)明显大于发病后第三天(21.5±2.7ml)和第七天(20.7±3.0ml)(p<0.01)。这些结果表明,通过二维超声心动图和我们的改良模型可以对梗死面积以及左心室容积进行定量和连续评估,并且我们的算法适用于此目的。

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