Fujii J, Watanabe H, Kato K
Jpn Heart J. 1976 Sep;17(5):630-48. doi: 10.1536/ihj.17.630.
The left ventricular wall motions in 53 patients with myocardial infarction and 14 normal subjects were studied by echocardiography and B-scan imaging (ultrosono-cardiokymography, ultrasono-cardiotomography). (1) Abnormal left ventricular wall motions corresponding to the electrocardiographic sites of infarction were seen in the echocardiograms in 80 % of total patients and 100 % of acute cases. Exaggerated wall motion in opposing noninfarcted areas was seen in 50 % of acute cases and 10 % of old cases. Quantitative analysis of asynergy could be made by comparing PWE, SE and those ratios to EDD-ESD of infarcted hearts with those of normal hearts. (2) In acute myocardial infarction, abnormal motions of left ventricular wall are marked in acute phase and diminished in extent gradually in recovery phase. But in some cases, echo-demonstrated segmental dyskinesis did not disappear in recovery phase, possibly due to the presence of irreversible myocardial damage. (3) Echographic thickness of the infarcted wall was less increased then normals or was not increased during systole and decreased when bulged out in some cases, indicating the existence of necrotized muscle. Moreover, multiple echoes sometimes seen between endocardial and epicardial echoes of infarcted myocardium were considered to display the fibrosis of the infarcted myocardium. (4) Abnormal echocardiographic motions of septum and posterior wall were observed in some cases who had no electrocardiographic abnormalities which suggest septal or posterior wall involvement. Echocardiography could detect another affected area of the left ventricle which could not be detected by electrocardiography. (5) Echocardiography in combination with B-scan imaging (UCKG, UCTG) can detect not only the location, but also the size and extent of myocardial infarction. (6) The results of this study indicate that echocardiography and B-scan imaging (UCKG, UCTG) are sensitive methods in detecting the size and location of asynergy and making a precise diagnosis of myocardial infarction. But it is necessary to distinguish abnormal septal and posterior wall motions observed in right ventricular volume overload, complete LBBB or PMD(COCM) from those of myocardial infarction.
采用超声心动图和B超成像（超声心动记波法、超声心动断层摄影术）对53例心肌梗死患者及14例正常受试者的左心室壁运动进行了研究。（1）在超声心动图中，80%的全部患者及100%的急性病例可见与心电图梗死部位相对应的左心室壁运动异常。50%的急性病例及10%的陈旧病例可见梗死相对非梗死区域的室壁运动增强。通过比较梗死心脏与正常心脏的PWE、SE以及这些参数与EDD - ESD的比值，可对不同步进行定量分析。（2）在急性心肌梗死中，左心室壁的异常运动在急性期明显，在恢复期范围逐渐减小。但在某些病例中，超声显示的节段性运动障碍在恢复期并未消失, 可能是由于存在不可逆的心肌损伤。（3）梗死壁的超声厚度较正常人增加较少，或在收缩期未增加，在某些病例中膨出时变薄，提示存在坏死心肌。此外，梗死心肌的心内膜和心外膜回声之间有时可见多条回声，被认为显示了梗死心肌的纤维化。（4）在一些无提示室间隔或后壁受累的心电图异常的病例中，观察到室间隔和后壁的超声心动图运动异常。超声心动图可检测到心电图无法检测到的左心室另一受累区域。（5）超声心动图与B超成像（UCKG、UCTG）相结合不仅可以检测心肌梗死的部位，还可以检测其大小和范围。（6）本研究结果表明，超声心动图和B超成像（UCKG、UCTG）是检测不同步大小和部位并对心肌梗死做出准确诊断的敏感方法。但有必要将右心室容量负荷过重、完全性左束支传导阻滞或PMD（COCM）中观察到的室间隔和后壁异常运动与心肌梗死的异常运动区分开来。
