Nixon J V, Narahara K A, Smitherman T C
Circulation. 1980 Dec;62(6):1248-55. doi: 10.1161/01.cir.62.6.1248.
To determine whether real-time two-dimensional echocardiography (2-D echo) can estimate the extent of myocardial involvement in patients with acute myocardial infarction (MI), regional wall motion on serial short-axis 2-D echo recordings was analyzed and the summed scores were compared with estimates of infarct involvement by thallium-201 reperfusion (Tl) and technetium-99m stannous pyrophosphate (99mTc-PYP) scintigraphy. Thirty-two consecutive male patients admitted with their first MI were studied; 10 patients had anterior, 16 had inferior and six had subendocardial MIs. Two patients were technically unsuitable for 2-D echo studies. Twenty patients had Tl scintigrams and 29 had 99MTc-PYP scintigrams. Summed 2-D echo scores correlated closely with estimates of infarct involvement by Tl (r = 0.87) and with estimates of infarct size by 99mTc-PYP (r = 0.74). The location of MI by 2-D echo agreed with the electrocardiographic location in 26 of 29 patients; discrepancies occurred in one inferior and two subendocardial MIs. Predischarge 2-D echo failed to identify extension of transmural infarction. However, two patients whose subendocardial MIs progressed to transmural MIs were identified. This study shows that 2-D echo is a valid method for the early estimation of the extent of myocardial involvement in patients with acute MI, especially transmural MIs. In particular, 2-D echo correlates closely with Tl reperfusion scintigraphy because both detect areas of ischemia and infarction.
为了确定实时二维超声心动图（2-D 回声）能否评估急性心肌梗死（MI）患者心肌受累的程度，对系列短轴 2-D 回声记录上的节段性室壁运动进行了分析，并将总分与通过铊-201 再灌注（Tl）和锝-99m 焦磷酸亚锡（99mTc-PYP）闪烁扫描术对梗死累及范围的评估结果进行比较。对 32 例因首次发生心肌梗死而入院的连续男性患者进行了研究；10 例患者为前壁心肌梗死，16 例为下壁心肌梗死，6 例为心内膜下心肌梗死。2 例患者在技术上不适合进行 2-D 回声研究。20 例患者进行了 Tl 闪烁扫描，29 例患者进行了 99mTc-PYP 闪烁扫描。2-D 回声总分与 Tl 对梗死累及范围的评估结果密切相关（r = 0.87），与 99mTc-PYP 对梗死面积的评估结果密切相关（r = 0.74）。2-D 回声显示的心肌梗死部位与 29 例患者中的 26 例心电图所示部位一致；在下壁心肌梗死和 2 例心内膜下心肌梗死中出现了差异。出院前的 2-D 回声未能识别透壁性梗死的扩展。然而，识别出了 2 例心内膜下心肌梗死进展为透壁性心肌梗死的患者。本研究表明，2-D 回声是早期评估急性心肌梗死患者心肌受累程度的有效方法，尤其是透壁性心肌梗死。特别是，2-D 回声与 Tl 再灌注闪烁扫描密切相关，因为两者都能检测到缺血和梗死区域。
