多巴酚丁胺负荷超声心动图对左室心尖部血栓与存活心肌的研究

Study on the dobutamine stress echocardiographic test for left ventricular apical thrombus and myocardial viability

目的旨在探讨是否在常规2-DE左室心尖部血栓的出现预示无存活心肌的存在。方法80例心肌梗死患者接受DSE检查,根据心室内有无血栓分为血栓组(1组)及无血栓组(2组),比较两组的室壁运动积分及射血分数。结果48例患者被证实/高度怀疑有左室血栓(1组),32例患者无左室血栓(2组)。1组比2组有更高的室壁积分;1组的32(67%)例及2组中8(25%)例患者证明在心尖节段无收缩储备即无存活心肌。结论在无存活心肌存在的相应节段左室心尖部血栓更易出现。

Objective The aim of this article was to determine whether the presence of left ventricular apical thrombus is a marker of nonviable myocardium. Methods Eighty patients with myocardial infarction （MI） were studied by dobutamine stress echocardiography （DSE） . Left ventricular apical was identified by echocardiographic criteria and the patients were thereafter divided into two groups： those with definite and highly suspicious echocardiograms for left ventricular thrombus （groupl） and those without echocardiographic evidence of thrombus （group2） . The wall motion score （WMS） and left ventricular ejection fraction （LVEF） in group 1 were compared with those in group 2. Results Totally 48 patients had definite or highly suspicious findings for left ventricular thrombus （group 1 ） ,and 32 patients had no thrombus （group 2）. Group 1 had sighificantly higher WMS and LVEF compared with those in group 2. Thirty-two patients （67%） in group 1 and 8 （25%） patients in group 2 demonstrated no contractile reserve in the apical segements and were consistent with lack of viability. Conclusions left ventricular apical thrombus is more likely to appear in the corresponding segments where myocardial viability is absent.