缬沙坦对急性心肌梗死后左室重塑的影响

Effects of valsartan on the left ventricular remodeling following acute myocardial infarction

目的 观察缬沙坦对急性心肌梗死 (AMI)后左室重塑的阻抑作用。方法 将 72例AMI患者随机分为常规治疗组 36例、缬沙坦治疗组 36例 ,并于AMI后 2周、2 4周分别进行超声心动图和平衡法核素心室造影 ,测定左室心肌质量、左室收缩功能和舒张功能 ,了解缬沙坦对AMI后左室重塑的阻抑作用。结果 AMI后 2 4周时 ,缬沙坦与常规治疗组比较 ,室间隔厚度、左室后壁厚度、左室舒张末内径和左室心肌质量指数均明显降低 ,差异有统计学意义(P <0 .0 5或P <0 .0 1)。AMI后 2 4周时 ,缬沙坦治疗组与对照组比较 ,左室射血分数明显增加 (P <0 .0 1) ,左室高峰射血率明显升高 (P <0 .0 1) ,左室高峰射血率时间显著下降 (P <0 .0 5 ) ,同时左室高峰充盈率明显升高 (P <0 .0 5 ) ,左室高峰充盈率时间显著下降 (P <0 .0 1)。结论 缬沙坦能明显减轻心肌梗死后心肌肥厚和左室重塑 ,改善左室功能。

Objective To compare the inhibitory effects of valsartan on left ventricular remodeling (LVRM) after acute myocardial infarction (AMI).Methods A total of 72 patients with AMI entered into the study.Thirty-six patients were randomized to conventional treatment group,36 patients to valsartan treatment group.At the second week,and 24th week after AMI,the left ventricular myocardium was measured by echocardiogram,and the parameters of left ventricular systolic and diastolic function were measured by equilibrium radionuclide angiography.Results At 24th week,IVST,LVPWT,LVDd and LVMI in valsartan treatment groups were significantly decreased as compared with conventional treatment group(P< 0.05 or P< 0.01).At 24th week,LVEF and LPFR in valsartan treatment group were significantly increased (P< 0.05 or P< 0.01) as compared with those in conventional treatment group,respectively.LTPER and LTPFR in valsartan group were decreased as compared with the conventional treatment group,respectively(P< 0.05 or P< 0.01).Conclusion Valsartan might significantly reduce myocardial hypetrothy and LVRM following AMI.Valsartan improves the left ventricular systolic function.