Petersen C L, Gadsbøll N, Stadeager C, Torp-Petersen C, Nielsen J R, Jensen B H, Høilund-Carlsen P F, Dige-Petersen H
Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Denmark.
Am J Cardiol. 1995 Apr 1;75(10):659-64. doi: 10.1016/s0002-9149(99)80649-3.
We describe the spontaneous long-term changes in right (RV) and left (LV) ventricular performance during a 7-year period after acute myocardial infarction (AMI). Radionuclide ventriculography was performed in the second week after AMI in 201 patients. RV and LV ejection fractions, and LV end-diastolic and end-systolic volumes were determined. A follow-up after 7 years was performed in 55 survivors. Of these, 16 patients were also examined after 1 year. During the 7-year follow-up period, LV ejection fraction decreased from 0.49 to 0.45 (p < 0.01). LV end-diastolic volume increased from 161 to 210 ml (30%) (p < 0.01), and LV end-systolic volume from 83 to 123 ml (48%) (p < 0.01). In patients without recurrent AMI, coronary artery bypass grafting surgery, or angiotensin-converting enzyme inhibitor therapy (n = 37) during follow-up, no change in average LV ejection fraction was observed. Nevertheless, this subgroup had substantial increases in LV end-diastolic volume, from 157 to 190 ml (21%) (p = 0.002) and in LV end-systolic volume, from 80 to 105 ml (31%) (p < 0.001). In a subgroup of patients also reinvestigated after 1 year (n = 16), there was a 15% increase in LV end-diastolic volume the first year after AMI with an additional 10% increase in LV end-diastolic volume between years 1 and 7. Corresponding figures for LV end-systolic volume were 20% and 12%, respectively. Hardly any association was apparent between LV ejection fraction, LV end-diastolic volume, and LV stroke volume at discharge for subsequent LV dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)
我们描述了急性心肌梗死（AMI）后7年期间右心室（RV）和左心室（LV）功能的自发性长期变化。对201例患者在AMI后第二周进行了放射性核素心室造影。测定了右心室和左心室射血分数，以及左心室舒张末期和收缩末期容积。对55名幸存者进行了7年的随访。其中，16名患者在1年后也接受了检查。在7年的随访期内，左心室射血分数从0.49降至0.45（p<0.01）。左心室舒张末期容积从161ml增加到210ml（30%）（p<0.01），左心室收缩末期容积从83ml增加到123ml（48%）（p<0.01）。在随访期间未发生复发性AMI、冠状动脉搭桥手术或未接受血管紧张素转换酶抑制剂治疗的患者（n=37）中，平均左心室射血分数未观察到变化。然而，该亚组的左心室舒张末期容积从157ml大幅增加到190ml（21%）（p=0.002），左心室收缩末期容积从80ml增加到105ml（31%）（p<0.001）。在1年后也再次接受检查的患者亚组（n=16）中，AMI后第一年左心室舒张末期容积增加了15%，在第1年至第7年期间左心室舒张末期容积又额外增加了10%。左心室收缩末期容积的相应数字分别为20%和12%。出院时左心室射血分数、左心室舒张末期容积和左心室每搏输出量与随后的左心室扩张之间几乎没有明显关联。（摘要截短于250字）
