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[缺血性心肌病的超声心动图评估]

[Echocardiographic evaluation of ischemic cardiopathy].

作者信息

Asin Cardiel E, Yuste P, Señor J, Palma J, Martínez-Bordiu C

出版信息

Arch Inst Cardiol Mex. 1976 Jan-Feb;46(1):46-58.

PMID:938150
Abstract

We studied a group of patients with ischemic heart disease divided into two groups: Group I coronary insufficiency. Group II myocardial infaction. We centered the work on the following aspects: analysis of the contractility; evaluation of the movement of the ventricular wall and of the septum; movement of the mitral valve; diagnosis of ventricular dyskinesias, akinesias, and hypokinesias. The patients in group I did not show significant alterations in the values of the ejection fraction and speed of circunferential shortening. The mean values of these parimeters are significantly less than the group of patients with infarcts, and 41% of these patients have EF less than 50% and Vcf less than 0.9. We did not find a correlation between these perimeters and the localization of the infarct. The velocity of the posterior ventricular wall was disminished in both groups of patients. The amplitude of movement of the posterior wall was reduced in the group of patients with infarctions. These parimeters were more altered in the posterior infarcts than in those with anterior localization and they are more an index of the state of the posterior wall than of the ventricular contractility considered overall, contary to mitral descriptions. In 3 cases of acute infarct we found paradoxical movement of the septum, which normalized itself in one patient in 6 months. In 6 other patients with old infarct we observed localized dyskinesias of the septum and of the free wall of the left ventricle. The mitral valve appears altered in a great proportion of coronary patients the most notorious characteristics being: a decrease in the EF pendent; an increase of the F index. These findings are considered in relation with the ventricular pressures and with the degree of distensibility of the left ventricle.

摘要

我们研究了一组缺血性心脏病患者,将其分为两组:第一组为冠状动脉供血不足,第二组为心肌梗死。我们的工作集中在以下几个方面:收缩性分析;心室壁和室间隔运动评估;二尖瓣运动;心室运动障碍、运动不能和运动减弱的诊断。第一组患者的射血分数和圆周缩短速度值未显示出明显改变。这些参数的平均值明显低于梗死患者组,且这些患者中有41%的射血分数低于50%,圆周纤维缩短速度低于0.9。我们未发现这些参数与梗死部位之间存在相关性。两组患者的心室后壁速度均降低。梗死患者组后壁的运动幅度减小。与二尖瓣的情况相反,这些参数在后壁梗死中比在前壁梗死中改变更大,它们更多地是后壁状态的指标,而非整体心室收缩性的指标。在3例急性梗死患者中,我们发现室间隔矛盾运动,其中1例患者在6个月后恢复正常。在另外6例陈旧性梗死患者中,我们观察到室间隔和左心室游离壁的局限性运动障碍。在很大一部分冠心病患者中,二尖瓣出现改变,最显著的特征是:E峰降低;F指数增加。这些发现与心室压力和左心室扩张程度有关。

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