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人类急性透壁性心肌梗死时的左心室顺应性

Left ventricular compliance in acute transmural myocardial infarction in man.

作者信息

Bertrand M E, Rousseau M F, Lefebvre J M, Lablanche J M, Asseman P H, Carre A G, Lekieffre J P

出版信息

Eur J Cardiol. 1978 Jun;7 Suppl:179-93.

PMID:668762
Abstract

130 patients with recent transmural myocardial infarction were studied in order to evaluate changes in left ventricular compliance. Left heart catheterization and cineangiographic left ventriculography were performed. The modulus of chamber stiffness (K) was determined from the slope of the linear relation between volume stiffness (dP/dv) and pressure; the modulus of muscle stiffness was evaluated by the Laird index (asymptotic slope of logP vs log V). Patients were divided in 3 groups: Group A included 5 patients studied before and after myocardial infarction who experienced an increase in the modulus of chamber and muscle stiffness after infarction. Group B included 10 patients who were studied at the onset of infarct and 15 days later: this group demonstrated changes in LV compliance with, most often a rightwardshift of P-V curve in anterior infarct and inversely a leftward shift in posterior infarction. The 115 patients of Group B are roughly equally distributed in the areas of normal, increased or decreased compliance. Any correlation was found between the extent of asynergy and changes in modulus of chamber stiffness. However, ejection fraction or VCF were higher in patients with a reduction of compliance than in patients with an increase of compliance.

摘要

对130例近期发生透壁性心肌梗死的患者进行了研究,以评估左心室顺应性的变化。进行了左心导管检查和电影血管造影左心室造影。根据容积硬度(dP/dv)与压力之间线性关系的斜率确定心室硬度模量(K);通过莱尔德指数(logP对logV的渐近斜率)评估肌肉硬度模量。患者分为3组:A组包括5例在心肌梗死前后进行研究的患者,这些患者在梗死后心室和肌肉硬度模量增加。B组包括10例在梗死发作时和15天后进行研究的患者:该组显示左心室顺应性发生变化,在前壁梗死中P-V曲线最常向右移位,而后壁梗死则相反向左移位。B组的115例患者在顺应性正常、增加或降低的区域大致均匀分布。未发现协同失调程度与心室硬度模量变化之间存在任何相关性。然而,顺应性降低的患者的射血分数或心室周长缩短率高于顺应性增加的患者。

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