Fujiwara S, Motoki K, Oshika H, Tomobuchi Y, Ueno Y, Nishio I
Department of Internal Medicine, Koyo Hospital.
J Cardiol. 1995 Oct;26(4):203-11.
The usefulness of magnetic resonance imaging (MRI) for estimating right ventricular function and the influence of left ventricular dysfunction on the performance of the right ventricle were assessed in 43 patients with chronic myocardial infarction (MI) and 14 control subjects (N) using electrocardiography-gated MRI and cardiac catheterization. Patients with MI were divided into three groups according to the location of the coronary lesions; 22 patients with left coronary artery lesion (LCA group), 13 with right coronary artery lesion (RCA group), and 8 with both left and right coronary artery lesions (L+R group). The right ventricular end-diastolic volume (RVEDV) and right ventricular ejection fraction (RVEF) were measured by Simpson's rule algorithm on transverse images of the right ventricle obtained at the end-systolic and end-diastolic phases. In 34 of the 43 patients, the same parameters of right ventricular function were calculated by the thermodilution method using a Swan-Ganz catheter with rapid response thermistor. Left ventricular ejection fraction (LVEF) and end-diastolic volume were determined from left ventriculography. The intraobserver reproducibility (11 cases, r = 0.97) and interobserver reproducibility (11 cases, r = 0.92) of RVEF measured by MRI were excellent. The RVEF and RVEDV determined from MRI were significantly correlated with those from the thermodilution method (RVEF: r = 0.56, RVEDV: r = 0.52). There was no difference in right ventricular end-diastolic volume index in any patient group. The RVEF was decreased in the L+R (41.0 +/- 4.5%, p < 0.01) and RCA (45.9 +/- 6.6%) groups, but there was no difference between the LCA (50.6 +/- 6.6%) and N (48.9 +/- 4.3%) groups.(ABSTRACT TRUNCATED AT 250 WORDS)
采用心电图门控磁共振成像(MRI)和心导管检查,对43例慢性心肌梗死(MI)患者和14名对照者(N)评估了MRI在估计右心室功能方面的有用性以及左心室功能障碍对右心室功能的影响。MI患者根据冠状动脉病变部位分为三组:22例左冠状动脉病变患者(LCA组),13例右冠状动脉病变患者(RCA组),8例左、右冠状动脉均有病变患者(L + R组)。通过Simpson规则算法在收缩末期和舒张末期获得的右心室横向图像上测量右心室舒张末期容积(RVEDV)和右心室射血分数(RVEF)。43例患者中的34例,使用带有快速响应热敏电阻的Swan - Ganz导管通过热稀释法计算右心室功能的相同参数。通过左心室造影确定左心室射血分数(LVEF)和舒张末期容积。MRI测量的RVEF的观察者内重复性(11例,r = 0.97)和观察者间重复性(11例,r = 0.92)极佳。MRI测定的RVEF和RVEDV与热稀释法测定的结果显著相关(RVEF:r = 0.56,RVEDV:r = 0.52)。任何患者组的右心室舒张末期容积指数均无差异。L + R组(41.0±4.5%,p < 0.01)和RCA组(45.9±6.6%)的RVEF降低,但LCA组(50.6±6.6%)和N组(48.9±4.3%)之间无差异。(摘要截短于250字)