选择性PTCA逆转心梗后左室重构疗效观察

CORONARY RECANALIZATION BY ELECTIVE ANGIOPLASTY REVERSE LEFT VENTRICULAR REMODELINGF AFTER MYOCARDIAL INFARCTION

经皮冠脉腔内成形术（ＰＴＣＡ）能否逆转冠心病（ＣＡＤ）患者的左室重构（ＬＶＲＭ），目前尚无一致认识，文章对成功地实施选择性ＰＴＣＡ的２５例患者，应用二维超声心动图（２ＤＥ）动态观察其围ＰＴＣＡ期左室身血分数（ＬＶＥＦ）、每搏量（ＳＶ）、左室舒张末容积（ＬＶＥＤＶ）及左室收缩末容积（ＬＶＥＳＶ）的演变。发现扩大的左室容积在围术期中明显缩小，其中ＬＶＲＭ者术后ＬＶＥＳＶ首先回缩。

To evaluate effects of PTCA on left ventricular function and volumes in the patients with left ventricular remodeling (LVRM). Fifteen patients with chronic myocardial infarction were divided into two groups: LVRM and Non- LVRM groups, Two- dimensional echocardiography (2DE) examination were done at time of pre- and post -PTCA at 1 ～3d. 7～10d and 20～40d. LVDV and LVESV were measured by using the modified of Simpson's method and recorded with videography. In LVRM group (n=7) LVESV had began to decline at 1～3d after PTCA. LVEDV and LVESV were decreased significantly than baseline at 7～10d after (both P<0.01). In Non-LVRM group (n= 8), LVEDV and LVESV were no change (both P=NS). LVEF and SV of peri-PTCA in two groups were kept stable (all P= NS). Authors believe that elective PTCA may reverse LVRM; Assessing left ventricular function with 2DE, LVESV and LVEDV is more sensitive than LVEF and SV.