急性心肌梗死并发房颤与冠状动脉病变及心力衰竭发生率关系探讨

The correlation of the rate of heart failure and coronary artery lesions with acute myocardial infarction which combined atrial fibrillation

目的 探讨急性心肌梗死 (AMI)并发房颤与冠状动脉病变及心力衰竭发生率的关系。方法 2 2 6例AMI在发病连续 7天心电监护中 ,30例新出现房颤为房颤组 ,选择同期 30例无房颤的AMI病人为非房颤组。根据房颤发生的时间又将房颤组 30例病人分为房颤早发组 ( 16例 ,房颤发生于AMI发病 2 4小时内 )和房颤迟发组 ( 14例 ,房颤发生在AMI发病 2 4小时后 ) ,比较房颤组与非房颤组及房颤早发组、迟发组间冠状动脉造影检查结果、心力衰竭发生率的差异。结果 房颤组与非房颤组比较 ,房颤组冠状动脉多支病变发生率高 ,并发心力衰竭也明显高于非房颤组。房颤早发组与迟发组比较 ,房颤早发组梗死相关动脉以右冠状动脉近端阻塞为主 ,而房颤迟发组梗死相关动脉以左冠状动脉前降支阻塞为多。结论 AMI并发房颤的患者有严重的冠状动脉病变 ,心肌梗死后房颤出现的时间与梗死相关冠状动脉有关。AMI并发房颤 。

Objective To evaluate the correlation of the rate of heart failure and coronary artery lesions with AMI combined atrial fibrillation.Mothods 30 patients who developed AF after the onset of AMI were classified into AF group,and 30 patients who did not develop AF after the onset of AMI were classified into non-AF groups.According to the onset time of AF,AF group was divided into two sub groups:subgroup1(n=16,AF developed within 24 hours after the onset of AMI) and subgroup2(n=14,AF developed>24 hours after the onset of AMI).Rate of heart failure and the angiographic out comes were compared in two groups and in two subgroups.Results The incidents of heart failure and multivessel disease was significantly higher in AF group than in non-AF group.Occlusion of the right proximal coronary was responsible for AMI at a significantly higher in subgroupl than in subgroup2,and occlusion of the left anterior descending branch was responsilbe for AMI at a significantly higher in subgroup2 than in sub groupl.Conclusion The patients who developed AF in acute course of MI had more severe coronary artery lesions.The onset time of AF in AMI was related to location of the infarcted lated coronary lesions.