Schartl M, Rutsch W, Paeprer H, Müller U
Z Kardiol. 1984 Jan;73(1):56-65.
The validity of two-dimensional echocardiography (2 DE) in the diagnosis of evolving myocardial infarction was assessed in 123 patients with a suspected acute myocardial infarction (chest pain for less than 4 hours). 84 patients developed a myocardial infarction, 39 did not. Detection and extent of a regional wall motion disorder in 2 DE were compared to ECG, enzymes, hemodynamics, coronary angiography and clinical data. The reliability of ECG and 2 DE in the diagnosis of acute myocardial infarction was found to be similar: sensitivity 89% for 2 DE, 96% for ECG; specificity 89% vs (= versus) 73%; positive predictive value 95% vs 89%; negative predictive value 79% vs 90%. This means that in most cases the ECG is a sufficient and reliable method in detecting or excluding acute myocardial infarction. Because of the equipment needed, the limited practicability and because of specific problems (distinction between new and old infarction), the 2 DE should be regarded as a supporting method to the ECG but not as an essential one in the diagnosis of acute myocardial infarction. The possible benefit of echocardiographic examination is the identification of high risk patients by non-invasive determination of the size of infarction. There was a significant correlation between the extent of wall motion disorder and the maximum CK levels as well as the incidence of cardiac complications such as hypotension, pulmonary congestion, and ventricular arrhythmias.
对123例疑似急性心肌梗死（胸痛持续时间小于4小时）的患者评估了二维超声心动图（2DE）诊断进展期心肌梗死的有效性。84例患者发生了心肌梗死，39例未发生。将2DE中局部室壁运动障碍的检测及范围与心电图、酶、血流动力学、冠状动脉造影及临床资料进行了比较。发现心电图和2DE诊断急性心肌梗死的可靠性相似：2DE的敏感性为89%，心电图为96%；特异性分别为89%和73%；阳性预测值分别为95%和89%；阴性预测值分别为79%和90%。这意味着在大多数情况下，心电图是检测或排除急性心肌梗死的一种充分且可靠的方法。由于所需设备、实用性有限以及存在特定问题（新旧梗死的区分），2DE应被视为心电图的辅助方法，而不是急性心肌梗死诊断中的必需方法。超声心动图检查的可能益处是通过无创测定梗死面积来识别高危患者。室壁运动障碍的程度与肌酸激酶（CK）最高水平以及心脏并发症如低血压、肺淤血和室性心律失常的发生率之间存在显著相关性。
