PCI术后AMI患者非梗死区冠脉血流储备的变化及其对左室功能的影响

Changes and effects of coronary flow reserve in non-infarcted myocardium after PCI

目的观察和分析急性心肌梗死(AMI)患者PCI术后非梗死区冠脉血流储备(CFR)的变化及其对左室功能的影响。方法 22名AMI患者PCI术后1周行二维超声心动图和多巴酚丁胺负荷实时心肌声学造影(MCE)检查,测量左室功能和梗死区、非梗死区CFR,比较非梗死区CFR与梗死区及正常对照组CFR;根据非梗死区CFR值将患者分为两组,比较两组远期左室功能的变化。结果非梗死区CFR值与正常对照组相比明显下降,非梗死区CFR与左室舒张末期容积呈负相关。结论 AMI后非梗死区心肌同样存在微循环功能障碍,非梗死区CFR值能预测AMI后远期左室功能。

AIM To assess the relationship of coronary flow reserve （CFR） in the non-infarcted myocardium and left ventricular functions in patients with acute myocardial infarction （AMI） undergoing coronary intervention. METHODS We enrolled 22 AMI patients undergoing coronary intervention. CFR in the non-infarcted myoeardium was compared with that in infarcted myocardium and normal myocardium by dobutamine real-time myocardial contrast eehocardiography at 1 week following coronary angioplasty. Left ventricular functions were assessed by two-dimensional echocardiography. Patients were divided into two groups according to the CFR value of the non-infarcted myocardium and changes of left ventricular functions were compared between groups. RESULTS CFR value decreased in non-infarcted myocardium compared with control group. Furthermore, there was a significant negative correlation between CFR in the non-infarcted region and left ventricular end diastolic volume （LVEDV） at 6 months following coronary angioplasty. CONCLUSION Microvascular dysfunction is commonly observed in the non-infarcted myocardium in AMI patients. The CFR value in the non-infarcted myocardium can predict left ventrieular function following AMI.