Imamura Y, Hirai H, Harada M, Tokuyama A, Yoshinuma M, Degawa T, Nishizawa S, Yabuki S, Machii K, Yamaguchi T
Third Department of Internal Medicine, Toho University School of Medicine, Tokyo.
J Cardiol. 1993;23(3):231-40.
Left ventricular systolic function in patients with acute myocardial infarction was assessed by Doppler echocardiographic measurement of left ventricular ejection flow velocity and maximum acceleration in 20 patients with initial acute anteroseptal myocardial infarction (group A) and 15 age-matched normal subjects. All patients underwent emergency reperfusion therapy by direct percutaneous transluminal coronary angioplasty (direct PTCA). Pulsed Doppler echocardiograms were obtained from sample volume immediately below the aortic valve in the apical long-axis view. Three parameters, peak velocity, ratio of acceleration time to ejection time (AT/ET) and maximum acceleration, were measured by the Doppler analysis program. Changes in the 3 parameters from the day of admission to the 3rd post-admission day were also observed in 15 patients. Although no significant difference was observed in AT/ET in the 2 groups, peak velocity and maximum acceleration in the patient group were significantly lower than those in the normal group (peak velocity: 90.8 +/- 13.1 vs 99.4 +/- 9.7 cm/sec, p < 0.05, maximum acceleration: 2,692.4 +/- 604.5 vs 3,410.2 +/- 712.5 cm/sec2, p < 0.01, respectively). Between the admission and 3rd day, peak velocity and AT/ET did not change significantly, but maximum acceleration increased significantly (2,720.5 +/- 676.7, 1st day vs 3,313.9 +/- 947.5 cm/sec2, 3rd day, p < 0.05). These results indicate that the maximum acceleration measured by pulsed Doppler echocardiography is useful for assessing global left ventricular systolic function in acute myocardial infarction. Direct PTCA results in improved ventricular systolic function on the 3rd post-operative day.
通过多普勒超声心动图测量左心室射血流速和最大加速度，对20例初发急性前间壁心肌梗死患者（A组）和15例年龄匹配的正常受试者的左心室收缩功能进行了评估。所有患者均接受了直接经皮冠状动脉腔内血管成形术（直接PTCA）进行急诊再灌注治疗。在心尖长轴视图中，从主动脉瓣下方紧邻处的取样容积获取脉冲多普勒超声心动图。通过多普勒分析程序测量三个参数：峰值速度、加速时间与射血时间之比（AT/ET）和最大加速度。还观察了15例患者从入院当天到入院后第3天这三个参数的变化。虽然两组在AT/ET方面未观察到显著差异，但患者组的峰值速度和最大加速度显著低于正常组（峰值速度：90.8±13.1对99.4±9.7cm/秒，p<0.05；最大加速度：2692.4±604.5对3410.2±712.5cm/秒²，p<0.01）。在入院和第3天之间，峰值速度和AT/ET没有显著变化，但最大加速度显著增加（第1天为2720.5±676.7，第3天为3313.9±947.5cm/秒²，p<0.05）。这些结果表明，脉冲多普勒超声心动图测量的最大加速度有助于评估急性心肌梗死患者的整体左心室收缩功能。直接PTCA可使术后第3天心室收缩功能得到改善。
