Bergovec M, Prpìć H, Mihatov S, Zigman M, Vukosavić D, Birtić K, Franceschi D, Barić L
Department of Internal Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
Eur Heart J. 1993 Aug;14(8):1102-9. doi: 10.1093/eurheartj/14.8.1102.
In 71 patients with a myocardial infarction (MI) (anterior in 27, inferior in 44 patients) global (GEF) and regional (REF) left ventricular ejection fractions were determined by radionuclide ventriculography and estimated from a 12 lead electrocardiogram (ECG), using Selvester's QRS score, during the early phase of a MI (15 to 21 days following MI). Global ejection fractions determined by radionuclide ventriculography and from ECG using Palmeri's method were: for all MI 40.8 +/- 12.6% vs 39.6 +/- 11.4%; in the group of anterior MI 32.0 +/- 10.0% vs 30.0 +/- 9.7% and in the group of inferior MI 48.9 +/- 12.0% vs 45.1 +/- 8.2%. A good correlation was found between global ejection fractions determined by radionuclide ventriculography and ECG, as well as between radionuclide GEF and ECG score. A weaker correlation was found between radionuclide GEF and enzymes among all MIs and in the group of anterior MI, while in the group of inferior MI this correlation was insignificant. The analysis of REF determined by radionuclide ventriculography and ECG showed the greatest abnormalities in the infarct region, but in the group of anterior MI, dysfunction was present in the whole left ventricle. The comparison of infarct-related REF derived from radionuclide ventriculography, with the QRS score showed a significantly higher correlation than the comparison with enzymes. ECG estimation of REF from a modified Palmeri's equation showed a better correlation with radionuclide REF than did GEF derived from the standard Palmeri's equation: anterior MI; r = 0.90 vs r = 0.82, inferior MI; r = 0.84 vs r = 0.69, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
在71例心肌梗死(MI)患者中(27例为前壁心肌梗死,44例为下壁心肌梗死),在心肌梗死早期(心肌梗死后15至21天),通过放射性核素心室造影测定左心室整体射血分数(GEF)和局部射血分数(REF),并使用塞尔维斯特QRS评分法从12导联心电图(ECG)进行估算。通过放射性核素心室造影和使用帕尔梅里方法从心电图测定的整体射血分数分别为:所有心肌梗死患者中为40.8±12.6%对39.6±11.4%;前壁心肌梗死组中为32.0±10.0%对30.0±9.7%,下壁心肌梗死组中为48.9±12.0%对45.1±8.2%。发现放射性核素心室造影测定的整体射血分数与心电图之间、放射性核素GEF与心电图评分之间存在良好相关性。在所有心肌梗死患者和前壁心肌梗死组中,放射性核素GEF与酶之间的相关性较弱,而下壁心肌梗死组中这种相关性不显著。对放射性核素心室造影和心电图测定的REF分析显示,梗死区域异常最为明显,但在前壁心肌梗死组中,整个左心室均存在功能障碍。将放射性核素心室造影得出的梗死相关REF与QRS评分进行比较,其相关性显著高于与酶的比较。根据改良的帕尔梅里方程从心电图估算REF,与放射性核素REF的相关性比标准帕尔梅里方程得出的GEF更好:前壁心肌梗死,r = 0.90对r = 0.82;下壁心肌梗死,r = 0.84对r = 0.69。(摘要截取自250字)