Lim Y J, Mishima M
Department of Cardiology, Kawachi General Hospital.
Nihon Rinsho. 1998 Apr;56(4):936-41.
Contrast echocardiography by venous injection of Albunex was used to visualize apical filling abnormality in patients with heart failure. 1. Contrast echocardiography was serially performed in 24 patients with acute anterior myocardial infarction. Wall motion of the infarct region was better at any stage in patients without apical filling abnormality than in patients with that. Improvement of filling abnormality was observed prior to that of wall motion abnormality. 2. Influence of tachycardia was assessed on apical filling in 20 patients with old myocardial infarction during rapid atrial pacing. Stress contrast echocardiography evidenced that tachycardia deteriorates apical filling abnormality in patients with chronic heart failure. 3. The effect of amrinone on apical filling was assessed in 60 patients with chronic anterior myocardial infarction. Apical filling abnormality improved in 46% of patients after amrinone infusion. The improvement of apical filling abnormality was closely related to the reduction of preload and improvement of asynergy in the infarct area after amrinone. Both adjunctive therapy and anticoagulant therapy should be considered if apical filling abnormalities are observed by contrast echocardiography.
通过静脉注射白蛋白微球进行对比超声心动图检查，以观察心力衰竭患者的心尖部充盈异常情况。1. 对24例急性前壁心肌梗死患者连续进行对比超声心动图检查。在任何阶段，无尖部充盈异常的患者梗死区域的壁运动情况均优于有尖部充盈异常的患者。在壁运动异常改善之前，观察到充盈异常有所改善。2. 对20例陈旧性心肌梗死患者在快速心房起搏期间评估心动过速对心尖部充盈的影响。负荷对比超声心动图显示，心动过速会使慢性心力衰竭患者的心尖部充盈异常恶化。3. 对60例慢性前壁心肌梗死患者评估氨力农对心尖部充盈的影响。氨力农输注后，46%的患者心尖部充盈异常得到改善。心尖部充盈异常的改善与氨力农输注后前负荷的降低以及梗死区域协同运动的改善密切相关。如果通过对比超声心动图观察到心尖部充盈异常，应考虑辅助治疗和抗凝治疗。
