Dolabchian Z L, Gabrielian R S
Kardiologiia. 1978 May;18(5):88-93.
Acute myocardial infarction is characterized by reduced contractile activity of the heart, which is manifested by pathological shifts in the phase structure of the left ventricular systole and parameters of hemodynamics corresponding to the syndrome of hypodynamia. The severity of the hypodynamia syndrome depends on the volume of the affected myocardium. On the basis of the degree of pathological shifts in the phase and hemodynamic indices, the authors distinguished several types of impaired cardiac contractility. In the course of stage-by-stage treatment applied on the principles of early activation, mobilization, and rehabilitation of patients, the dynamics differs with the type of the contractility disorder. In type I positive dynamics is revealed beginning with stage I, in type II beginning with stage II of treatment; in type III negative dynamics is noted in the early periods of the disease and positive dynamics in stage III of treatment. The differentiation of these types becomes very important in appraising the tactics, the prognosis, and the outcome of the disease. Close correlative relations were revealed between the phase indices and the indices of hemodynamics which allow more objective appraisal of the state of cardiac contractility in the acute period of myocardial infarction.
急性心肌梗死的特征是心脏收缩活动减弱，表现为左心室收缩期相结构的病理改变以及与动力不足综合征相对应的血流动力学参数改变。动力不足综合征的严重程度取决于受影响心肌的体积。根据相和血流动力学指标的病理改变程度，作者区分了几种类型的心脏收缩功能受损。在基于患者早期激活、动员和康复原则进行的分阶段治疗过程中，动力学因收缩功能障碍的类型而异。在I型中，从第一阶段开始就显示出正向动力学，在II型中从治疗的第二阶段开始；在III型中，在疾病早期观察到负向动力学，而在治疗的第三阶段出现正向动力学。这些类型的区分在评估疾病的治疗策略、预后和结果方面变得非常重要。已揭示相指标与血流动力学指标之间存在密切的相关性，这使得能够更客观地评估心肌梗死急性期心脏收缩功能的状态。
