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[心肌梗死后二尖瓣反流的超声心动图评估]

[Echocardiographic evaluation of mitral regurgitation after myocardial infarction].

作者信息

Piszczek I, Cieśliński A

机构信息

I Kliniki Kardiologii Instytutu Kardiologii AM, Poznaniu.

出版信息

Kardiol Pol. 1993 Sep;39(9):177-81.

PMID:8231014
Abstract

Pulsed Doppler and echocardiographic analysis of the incidence of mitral regurgitation (MR) was performed. Moreover, an attempt at finding out factors conducive to the development of MR in patients after myocardial infarction (MI) was undertaken. The study included 70 patients (53 males and 17 females) aged 29-70 years, mean age: 56 years, with (first in their life) Q-wave infarction. Twenty-eight of these patients (40%) had anterior wall MI, 34 (49%) had inferior wall MI and 8 (11%) had apical MI. Pulsed Doppler echocardiographic analysis was performed 3 months after MI. In 47 patients (67%), papillary muscle dysfunction with abnormal mitral valve leaflet closure was observed. MR was found in 37 (79%) of these patients. MR diagnosed by Doppler echocardiography was found to be a frequent complication of MI (53% of patients). In echocardiographic assessment, patients with Doppler MR had a significant enlargement of mitral anulus, LV dilatation and higher percentage of asynergic basal segments of the left ventricle as compared with patients without MR. These changes were more frequently observed in patients with inferior or apical infarctions and ejection fraction < 40%.

摘要

对二尖瓣反流(MR)的发生率进行了脉冲多普勒和超声心动图分析。此外,还尝试找出心肌梗死(MI)后患者发生MR的相关因素。该研究纳入了70例年龄在29 - 70岁之间(平均年龄56岁)的患者(53例男性和17例女性),均为首次发生Q波梗死。其中28例患者(40%)为前壁心肌梗死,34例(49%)为下壁心肌梗死,8例(11%)为心尖部心肌梗死。心肌梗死后3个月进行脉冲多普勒超声心动图分析。在47例患者(67%)中观察到乳头肌功能障碍伴二尖瓣叶关闭异常。在这些患者中,37例(79%)发现有二尖瓣反流。经多普勒超声心动图诊断的二尖瓣反流是心肌梗死常见的并发症(占患者的53%)。在超声心动图评估中,与无二尖瓣反流的患者相比,有多普勒二尖瓣反流的患者二尖瓣环明显增大、左心室扩张,左心室基底节段运动不协调的比例更高。这些变化在有下壁或心尖部梗死且射血分数<40%的患者中更常见。

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