左室功能的改变与陈旧性心肌梗死部位的关系

Relationship between sites of old myocardial infarction and changes of left ventricular function

目的应用彩色多普勒超声观察陈旧性心肌梗死(Oldmyocardialinfarction,OMI)患者的定位与左室功能。方法观察对象为42例心肌梗死患者和40位正常人。根据心肌梗死部位,分为前壁梗死组(OMI-AN)20例,下壁心肌梗死(OMI-IN)22例。用多普勒超声心动图研究左室收缩和舒张功能。结果OMI-AN组梗死部位瘢痕组织范围大于OMI-IN组,分别是OMI-AN(4.2±2.1)cm,OMI-IN(2.3±2.1)cm,(P<0.01),OMI-AN,OMI-IN和对照组左室舒张末内径分别为:(57.6±6.2)mm,(52.5±5.1)mm和(47.2±3.7)mm(P<0.01);左室射血分数(EF)分别是48.6±7,58.0±7和65.8±9,(P<0.05);E/A比值分别为0.99±0.14,0.72±0.25和1.3±0.23(P<0.05);Tei指数分别是0.72±0.14,0.49±0.18和0.38±0.12,(P<0.01);舒张早期充盈时间(DT)OMI-AN组短于OMI-AN组。结论心肌梗死部位与左室收缩舒张功能有关,OMI-AN组梗死范围较大,左室功能亦低于OMI-IN患者。

Objective To evaluate Doppler-derived indices in determining the relationship between systolic and diastolic left ventricular function and sites of oldmyocardial infarction.Methods A total of 42 patients with old myocardial infarction (OMI) and 40 normal subjects as controls were studied. According to the infarcted sites, the patients were devided into two groups:anterior wall OMI(OMI-AN),20 cases;inferiorwall OMI(OMI-IN),22 cases.Left ventricular function and Tei index were detected using color Doppler echocardiography.Tei index is defined as the sum of the isovolumic systole and isovolumic diastole times divided by ejection time.Results The areas of scar tissues in OMI-AN and OMI-IN groups were (4.1±2.1) cm and (2.3±2.5) cm respectively(P<0.01).Left ventricular end diastolic internal diameters in OMI-AN,OMI-IN and control groups were (57.6±6.2) mm,(52.5±5.1) mm,and (47.2±3.7) mm, respectively(P<0.01).Left ventricular ejection fractions (EF) in the three groups were 48.6±7,58.0±7, and 65.8±9, respectiviy (P<0.05).E/A were 0.99± 0.14,0.72± 0.25, and 1.3±0.23, respectively (P<0.05),significantly increased in OMI-AN group.The Tei indices were 0.72±0.14,0.49±0.18, and 0.38±0.12,respectively (P<0.01).Early diastolic filling time (DT) in OMI-IN group was shortened.Conclusions Myocardial infarted sites are related to the left ventricular systolic and diastolic functional changes.