不同部位心肌梗塞对左心室收缩力和心室重构的影响

Effects of Different Parts' Myocardial Infarction on Left Ventricular Contractility and Remodelling

利用心音、心电和心动超声同屏幕显示技术，对不同部位心肌梗塞恢复期病人和正常人测定给消心痛等扩血管药物前、后心脏四腔图的左室舒缩末期长、短径，容积，搏量和射血分数，同步记录袖带肱动脉血压，计算收缩末期左室压及压力容积关系线的斜率（Ｅｍａｘ）和Ｘ轴的截距（Ｖｏｐ）。结果显示，不同部位心肌梗塞后心室重构程度依次为正常组＜下壁＜前壁＜复合壁组；心肌收缩力减低依次为正常组＜下壁＜前壁＜复合壁组。说明不同梗塞部位对梗塞后心室重构和心室收缩力的影响程度不同。

To compare the effects of myocardial infarction (MI) in different parts of the heart on left ventricular contractility (VC) and left ventricular remodelling (VR), before drug administration and when there appeared blood pressure reductions of 1.33kPa and of 2.66kPa after sublingual administration of 2.5 ～5.0mg isosorbide dinitrate or 0.3～0.6mg nitroglycerin, the left ventricular (LV) end systolic and end diastolic long and short axis dimensions, volumes, stroke volume (SV) and ejection fraction (EF) were determined by use of simultaneous screen demonstration of B mode echocardiographic, phonocardiographic, and electrocardiographic examinations, with right arm blood pressure auto monitoring, in 31 normal subjects (control group) and in 31 convalescent post MI patients (MI group). The LV end systolic pressure, the slope of the LV end systolic pressure volume relation (ESPVR) line, and the intercept of the ESPVR line on the abscissa were calculated. The results showed that the degrees of ventricular remodelling (VR) were: control group<inferior MI subgroup≤anterior MI subgroup<extensive MI subgroup; and the degrees of myocardial contractility were: control group>inferior MI subgroup>anterior MI subgroup>extensive MI subgroup. It explain that MI in different parts of the heart affects the left ventricular contractility at different degrees.