Dabrowska-Kugacka A, Claeys M J, Rademakers F E
Department of Cardiology, University Hospital of Antwerp, Edegem, Belgium.
J Am Soc Echocardiogr. 1998 Jan;11(1):26-35. doi: 10.1016/s0894-7317(98)70117-8.
The aim of this study was to determine whether Doppler parameters assessed during dobutamine stress echocardiography in the early phase after myocardial infarction could discriminate patients with residual ischemia from those without. Thirty-six patients after a recent myocardial infarction with and without residual ischemia underwent dobutamine stress echocardiography, adenosine sestamibi scintigraphy, and coronary angiography within 2 weeks after the acute event. The only diastolic Doppler parameter discriminating the two groups was the isovolumic relaxation time (IVRT) measured at the peak of the dobutamine infusion. It became shorter in both groups but significantly more in patients without than in those with residual ischemia despite a larger increase in heart rate in the latter group. IVRT at rest was 78 +/- 18 msec and decreased with high-dose dobutamine to 54 +/- 11 msec in the control group and to 69 +/- 16 msec in the ischemic group (p < 0.01). In addition, the rate-corrected IVRT (IVRTc) was calculated: IVRTc = IVRT/sqrtRR. The value of IVRTc = 80 at peak dobutamine infusion is able to discriminate patients with residual ischemia from those without with a sensitivity of 80% and a specificity of 70%.
本研究的目的是确定在心肌梗死后早期进行多巴酚丁胺负荷超声心动图检查时评估的多普勒参数是否能够区分有残余缺血的患者和无残余缺血的患者。36例近期发生心肌梗死且有或无残余缺血的患者在急性事件发生后2周内接受了多巴酚丁胺负荷超声心动图检查、腺苷 sestamibi 闪烁显像和冠状动脉造影。唯一能区分两组的舒张期多普勒参数是在多巴酚丁胺输注峰值时测量的等容舒张时间（IVRT）。两组的IVRT均缩短，但无残余缺血的患者缩短得更明显，尽管后一组心率增加幅度更大。对照组静息时IVRT为78±18毫秒，高剂量多巴酚丁胺时降至54±11毫秒，缺血组降至69±16毫秒（p<0.01）。此外，计算了心率校正的IVRT（IVRTc）：IVRTc = IVRT/√RR。多巴酚丁胺输注峰值时IVRTc = 80能够区分有残余缺血的患者和无残余缺血的患者，敏感性为80%，特异性为70%。
