急性前壁心肌梗死介入治疗后左前降支远端血流频谱与左室收缩功能的关系

Left anterior descending distal flow pattern and left ventricular function after primary coronary stenting in acute myocardial infarction

目的 评价急性心肌梗死 (AMI)介入治疗 (PCI)后左前降支 (LAD)远端血流频谱形态与左室收缩功能的关系。方法 经胸多普勒超声心动图 (TTDE)探查 3 2例前壁AMI急诊PCI后第 3天LAD远端血流 ,测定室壁运动指数 (WMSI)和左室射血分数 (LVEF)。结果 LAD远端血流频谱舒张期减速时间 (DDT)≤ 60 0ms组 (A组 )WMSI及心肌标记物峰值高于DDT >60 0ms组 (B组 ) ;出现收缩早期逆向血流 (ESRF)组 (a组 )WMSI明显高于无ESRF组 (b组 ) ,LVEF明显低于b组。结论 LAD远端血流频谱DDT缩短及存在ESRF患者左室收缩功能低 ,ESRF可较DDT更好地反映左室收缩功能损伤程度。

Objective To evaluate the relation between left anterior descending (LAD) distal flow pattern and left ventricular function after primary coronary intervention (PCI) in anterior acute myocardial infarction (AMI) with transthoracic Doppler echocardiography (TTDE). Methods All 32 patients with anterior wall AMI underwent TTDE to record the left anterior descending coronary artery distal flow spectrum, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) at 3 days after successfully PCI. Results WMSI and myocardial enzyme were higher in the group of diastolic deceleration time (DDT) ≤600 ms (Group A) than that in the group of DDT>600 ms (Group B). The group with early systolic reverse flow (ESRF) (Group a) had a higher WMSI and lower LVEF than those in the group without ESRF (Group b). Conclusion Patients with shorter DDT and ESRF had poor left ventricular systolic function. By analysis of left anterior descending (LAD) distal flow pattern with TTDE, ESRF was better than DDT in predicting the reduction of left ventricular systolic function in the patients with AMI.