心肌梗死患者经皮冠状动脉介入治疗前后局部室壁运动速度变化及其意义

Local myocardium velocity changes in myocardial infarction patients after percuaneous coronary intervention.

目的 探讨心肌梗死患者经皮冠状动脉介入治疗 (PCI)对存活心肌功能恢复的影响。方法 对 2 6例接受PCI术的患者采用多普勒显像技术测定PCI术前后收缩期峰值速度 (Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度 (Va)及Ve/Va值的变化。推断PCI术中顿抑心肌的存在及PCI后冬眠心肌的功能恢复。结果 前壁组PCI术后 8周Vs较术前显著升高 (P <0 .0 1) ,Ve/Va值较术前有所升高 ,但无统计学差异 ;下壁组中PCI术后 8周Vs、Ve/Va值较术前明显升高 (P <0 .0 5 ) ,Va较术前也明显降低 (P <0 .0 5 )。结论 PCI术后 72h ,心肌舒缩功能无明显变化 ,PCI术后 8周 ,出现局部收缩功能的改善 ,室壁也可出现舒张功能的改善 ,推测其与术前侧支循环的形成有关。

Objective To study the effect of percuaneous coronary intervention(PCI) on the function recovery of survived myocardium in patients with myocardial infarction.Methods The changes of systolic velocity(Vs),early diastolic peak velocity(Ve),late diastolic peak velocity(Va),and Ve/Va were measured before and after PCI by Doppler tissue imaging in 26 patients in order to predict the stunning myocardium and hibernating myocardium during PCI.Results Vs was higher 8 weeks after PCI than that before PCI(P<0.01) and Ve/Va was increased in anterior wall group as compared with that before PCI,but with no statistical difference.Vs and Ve/Va were higher 8 weeks after PCI than that before PCI(P<0.05) and Va was lower than that before PCI in inferior wall group(P<0.05).Conclusion Myocardial function is not changeable 72 h after PCI.Local systolic and diastolic function in ventricular is improved 8 weeks after PCI,which maybe related to the formation of lateral branch circulation.