Mortelmans L, Scheys I, Brzostek T, Lesaffre E, De Roo M, Verstraete M, De Geest H, Van de Werf F
Department of Nuclear Medicine, University Hospital, Leuven, Belgium.
Nuklearmedizin. 1993 Jun;32(3):120-7.
The aim of the study was the functional re-evaluation of 296 patients 12 to 18 months after a double-blind trial evaluating the effect of tissue plasminogen activator (rt-PA) versus placebo given within 5 h of onset of symptoms caused by an acute myocardial infarction. All patients underwent rest-stress radionuclide angiography (Egna). For each exercise level the global left ventricular ejection fraction (LVEF) was calculated together with an estimate of regional wall motion abnormalities (RWMA). A clear difference of the total workload and the peak workload was found between both therapeutic groups. Discriminant analysis evaluating four parameters (LVEF at peak exercise and at the endpoint and the workload at those levels) revealed a beneficial therapeutic effect. The RWM at rest showed only a difference in the apico-inferior region. There were less wall motion abnormalities in the treated group. Radionuclide analysis demonstrated a larger functional capacity and a better coordination of myocardial contractility during stress RNA one year after thrombolytic therapy. At rest, no major differences were found between the hospital stage and the follow-up in both therapeutic groups one year later.
该研究的目的是对296例患者在双盲试验12至18个月后进行功能重新评估，该双盲试验评估了在急性心肌梗死引起的症状发作5小时内给予组织纤溶酶原激活剂（rt-PA）与安慰剂的效果。所有患者均接受静息-负荷放射性核素血管造影（Egna）。对于每个运动水平，计算整体左心室射血分数（LVEF）以及区域壁运动异常（RWMA）的估计值。在两个治疗组之间发现了总工作量和峰值工作量的明显差异。评估四个参数（运动峰值和终点时的LVEF以及这些水平时的工作量）的判别分析显示出有益的治疗效果。静息时的RWMA仅在心尖下区域存在差异。治疗组的壁运动异常较少。放射性核素分析表明，溶栓治疗一年后，在负荷RNA期间，功能能力更大，心肌收缩力协调性更好。静息时，一年后两个治疗组的住院阶段和随访之间未发现重大差异。
