Fedele F, Arata L, Giannico S, Pastore L R, Di Renzi L, Penco M, Agati L, Dagianti A
G Ital Cardiol. 1981;11(3):310-20.
The feasibility of echocardiography in detecting left ventricle wall motion abnormalities, their location and their spontaneous or therapeutic regression, was assessed performing monodimensional and two-dimensional echocardiography in 35 patients with stable effort angina, without previous AMI. A control group of 10 normal subjects was also studied. The Authors evaluated echocardiographic findings on subjects at rest, during supine bicycle exercise and after sublingual nitroglycerin administration, defining the quality of wall motion as normal, hypokinetic, akinetic or dyskinetic in M-mode, and normal or asynergic in 2-D. They also analyzed, in M-mode, some echocardiographic indices of regional left ventricle function (IVSE, PWE, VIVS, VPW, delta TS, delta TP), and, in 2-D, the percent of systo-diastolic endocardial outline changes versus standard references in 7 sectors of left ventricle (anterior, lateral, inferior, septal in short-axis, septal, postero-lateral in long-axis, and apical) by means of a HP 9845B Computer, interfaced to a Digitizer. The percentage of feasibility of exercise echocardiography has been 60% in M-Mode, and 70% in 2-D. Mono and two-dimensional findings were normal in all patients at rest, whereas, during exercise, 57% of them, in M-mode, and 88% in 2-D, showed segmental contraction abnormalities. The Authors conclude that exercise echocardiography, though technically difficult, is feasible, Both M-mode and 2-D involve peculiar advantages or disadvantages. They provide, however, a valuable tool in detecting the mechanical consequences of exercise-induced regional myocardial ischemia and may be applicable in patients with equivocal exercise test.
在35例无既往急性心肌梗死(AMI)病史的稳定型劳力性心绞痛患者中,通过单维和二维超声心动图评估了超声心动图检测左心室壁运动异常、其位置以及自发或治疗性消退情况。还研究了10名正常受试者组成的对照组。作者评估了静息状态、仰卧位自行车运动期间以及舌下含服硝酸甘油后受试者的超声心动图表现,在M型超声心动图中将壁运动质量定义为正常、运动减弱、运动消失或运动障碍,在二维超声心动图中将其定义为正常或不协调。他们还在M型超声心动图中分析了一些左心室局部功能的超声心动图指标(室间隔增厚率、后壁增厚率、室间隔运动速度、后壁运动速度、心肌运动时间间期差值、心肌运动峰值速度差值),在二维超声心动图中,通过与数字化仪相连的惠普9845B计算机,分析左心室7个节段(前壁、侧壁、下壁、短轴面室间隔、长轴面室间隔、后侧壁、心尖)收缩末期和舒张末期心内膜轮廓相对于标准参考的变化百分比。运动超声心动图的可行性在M型超声心动图中为60%,在二维超声心动图中为70%。所有患者静息时的单维和二维检查结果均正常,而在运动期间,M型超声心动图中有57%的患者、二维超声心动图中有88%的患者出现节段性收缩异常。作者得出结论,运动超声心动图虽然技术上有难度,但却是可行的。M型和二维超声心动图都有其独特的优缺点。然而,它们为检测运动诱发的局部心肌缺血的机械后果提供了一个有价值的工具,并且可能适用于运动试验结果不明确的患者。