Bishop H L, Gibson R S, Stamm R B, Beller G A, Martin R P
Am Heart J. 1981 Dec;102(6 Pt 1):965-71. doi: 10.1016/0002-8703(81)90478-6.
In 18 consecutive patients with a new murmur following acute myocardial infarction (AMI), examination by two-dimensional echocardiography (2DE) correctly excluded ventricular septal defects (VSD) in eight patients and enabled direct visualization of the VSD in 10 patients. In three patients, 2DE was the first technique to establish the diagnosis. In all patients with VSD, 2DE diagnosis was confirmed by catheterization, surgery, and/or postmortem examination. In six patients with VSD, 2DE contrast studies were performed and were positive. 2DE enabled localization of the VSD in all patients (five inferior, five anterior). To evaluate left ventricular (LV) function, a 2DE wall motion index (WMI) was calculated using an 11 segment model of the LV. While there was no difference (p greater than 0.2) in AMI-VSD survivors versus nonsurvivors in age, kinase, and AVO2 difference, there was no overlap in WMI (p = 0.004) of survivors (0.80 +/- 0.36) versus nonsurvivors (1.66 +/- 0.19). Thus 2DE allows accurate detection and localization of postmyocardial infarction VSD and enables determination of prognosis of these patients.
在18例急性心肌梗死（AMI）后出现新杂音的连续患者中，二维超声心动图（2DE）检查正确排除了8例患者的室间隔缺损（VSD），并使10例患者的VSD得以直接可视化。在3例患者中，2DE是确立诊断的首要技术。在所有VSD患者中，2DE诊断均经心导管检查、手术和/或尸检证实。在6例VSD患者中，进行了2DE造影检查，结果为阳性。2DE能够在所有患者中确定VSD的位置（5例在下壁，5例在前壁）。为评估左心室（LV）功能，使用LV的11节段模型计算了2DE壁运动指数（WMI）。虽然AMI-VSD存活者与非存活者在年龄、激酶和动静脉血氧含量差方面无差异（p大于0.2），但存活者（0.80±0.36）与非存活者（1.66±0.19）的WMI无重叠（p = 0.004）。因此，2DE可准确检测和定位心肌梗死后VSD，并能确定这些患者的预后。
