Cabin H S, Roberts W C
Am Heart J. 1982 Aug;104(2 Pt 1):216-20. doi: 10.1016/0002-8703(82)90195-8.
The percent of left ventricular wall (including ventricular septum) replaced by scar was determined in 70 necropsy patients with a healed transmural myocardial infarct (MI). The MI involved from 1% to 55% (mean 13%) of the left ventricular wall. The ages at death of the patients ranged from 25 to 82 years (mean 62) and did not significantly correlate with MI size (r = -0.12). Of the 70 patients, 41 (59%) had unequivocal histories of an acute MI: the interval from the MI to death in them ranged from 2 to 276 months (mean 50) and correlated negatively with MI size (r = -0.32, p less than 0.05), and the age at the MI ranged from 26 to 79 years (mean 58) and did not correlate with MI size (r = -0.05). The four major epicardial coronary arteries were examined quantitatively in 56 patients; the number of coronary arteries with severe narrowing ranged from one to four (mean 2.9) and did not correlate with MI size (r = -0.24). The mean MI size in the 12 patients with and in the 44 without severe narrowing of the left main coronary artery was identical (each 13%). The entire lengths of the right, left anterior descending, and left circumflex coronary arteries in the 56 patients were divided into 5 mm long segments and the amounts of cross-sectional area narrowing in each of the resulting 2489 segments were determined by histologic examination. The percent of 5 mm segments with severe (cross-sectional area narrowing 76% to 100%) narrowing by atherosclerotic plaques in each patient ranged from 3% to 93% (mean 44% and did not correlate with MI size (r = -0.20). When the 28 patients with an MI involving greater than 10% of the left ventricular wall were compared to those with an MI involving less than or equal to 10%, a similar overall percentage of 5 mm segments of coronary artery was severely narrowed (43% vs 42%). In addition, a similar percentage of segments was narrowed severely in each of the three major epicardial coronary arteries. Thus in our necropsy patients with a healed transmural MI, the MI size correlated with length of survival after an acute MI (in patients with definite histories of an acute MI) but not with age at death or with the amount, location, or extent of coronary arterial narrowing by atherosclerotic plaques.
在70例有愈合透壁性心肌梗死（MI）的尸检患者中，测定了被瘢痕取代的左心室壁（包括室间隔）的百分比。MI累及左心室壁的1%至55%（平均13%）。患者的死亡年龄在25至82岁之间（平均62岁），与MI大小无显著相关性（r = -0.12）。在这70例患者中，41例（59%）有明确的急性MI病史：他们从MI到死亡的间隔时间为2至276个月（平均50个月），与MI大小呈负相关（r = -0.32，p小于0.05），MI时的年龄在26至79岁之间（平均58岁），与MI大小无相关性（r = -0.05）。对56例患者的四条主要心外膜冠状动脉进行了定量检查；严重狭窄的冠状动脉数量从1条到4条不等（平均2.9条），与MI大小无相关性（r = -0.24）。左主干冠状动脉严重狭窄的12例患者和无严重狭窄的44例患者的平均MI大小相同（均为13%）。将56例患者的右冠状动脉、左前降支冠状动脉和左旋支冠状动脉的全长分成5毫米长的节段，通过组织学检查确定每个节段的横截面积狭窄量。每位患者中被动脉粥样硬化斑块严重狭窄（横截面积狭窄76%至100%）的5毫米节段的百分比在3%至93%之间（平均44%），与MI大小无相关性（r = -0.20）。当将28例MI累及左心室壁大于10%的患者与MI累及左心室壁小于或等于10%的患者进行比较时，冠状动脉5毫米节段严重狭窄的总体百分比相似（43%对42%）。此外，在三条主要心外膜冠状动脉中，严重狭窄节段的百分比也相似。因此，在我们有愈合透壁性MI的尸检患者中，MI大小与急性MI后的生存时间相关（在有明确急性MI病史的患者中），但与死亡年龄或动脉粥样硬化斑块导致的冠状动脉狭窄的数量、位置或程度无关。
