Taniguchi H, Iwasaka T, Sugiura T, Takayama Y, Inada M
Division of Cardiology, Kansai Medical University, Osaka, Japan.
Chest. 1993 Jun;103(6):1688-91. doi: 10.1378/chest.103.6.1688.
To evaluate the clinical characteristics of patients with anteroseptal myocardial infarction (MI) initially presenting with pulmonary edema, we analyzed 58 patients with anteroseptal MI who underwent emergency coronary arteriography that revealed single-vessel disease of the left anterior descending coronary artery. Of the 58 patients, pulmonary edema was observed in 24 patients (group A) and was absent in 34 patients (group B). Pulmonary capillary wedge pressure was significantly higher, and cardiac output was significantly lower in group A. The site of coronary stenosis, maximum serum creatinine kinase value, and wall motion point score did not differ between the two groups. However, the incidence of previous hypertension and posterior wall thickness > or = 11 mm was significantly higher in group A than in group B (p < 0.001 and p < 0.05, respectively). Thus, impaired left ventricular diastolic filling in the non-MI segments due to higher incidence of hypertension and left ventricular hypertrophy was considered to be the possible cause of pulmonary edema.
为评估最初表现为肺水肿的前间隔心肌梗死（MI）患者的临床特征，我们分析了58例接受急诊冠状动脉造影的前间隔MI患者，这些患者显示左前降支冠状动脉单支血管病变。在这58例患者中，24例患者（A组）出现肺水肿，34例患者（B组）未出现肺水肿。A组的肺毛细血管楔压显著更高，心输出量显著更低。两组之间冠状动脉狭窄部位、血清肌酐激酶最大值和室壁运动积分无差异。然而，A组既往高血压发病率和后壁厚度≥11 mm的发生率显著高于B组（分别为p<0.001和p<0.05）。因此，高血压和左心室肥厚发生率较高导致非MI节段左心室舒张期充盈受损被认为是肺水肿的可能原因。
