Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myo...Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction, and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28.86% vs. 36.8%),and had a higher left ventricle end systolic pressure, ±dp/dt _ max , and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group. Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function .展开更多
Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stres...Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography （LDSE） can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time. Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments （57%） were viable during LDSE. 26 patients （38%） with viability and 43 （62%） without. In viable group, left ventricular ejection fraction （LVEF） was increased （P 〈 0.05）, and left ventricular end systolic volume index （LVESVI） and wall motion score （WMS） were decreased （P 〈 0.05 and P 〈 0.01） significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased （P 〈 0.01）, and LVESVI and left ventricular end diastolic volume index （LVEDVI） were increased （P 〈 0.05） significantly after 6 months, and the WMS did not changed （P 〉 0.05 ）. LVEF increased （P 〈 0.05 ） and WMS decreased （P 〈 0.05） on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling. Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.展开更多
文摘Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction, and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28.86% vs. 36.8%),and had a higher left ventricle end systolic pressure, ±dp/dt _ max , and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group. Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function .
文摘Objectives The long-term benefit of late reperfusion of infarct-related artery （IRA） after acute myocardial infarction （AMI） is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography （LDSE） can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time. Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments （57%） were viable during LDSE. 26 patients （38%） with viability and 43 （62%） without. In viable group, left ventricular ejection fraction （LVEF） was increased （P 〈 0.05）, and left ventricular end systolic volume index （LVESVI） and wall motion score （WMS） were decreased （P 〈 0.05 and P 〈 0.01） significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased （P 〈 0.01）, and LVESVI and left ventricular end diastolic volume index （LVEDVI） were increased （P 〈 0.05） significantly after 6 months, and the WMS did not changed （P 〉 0.05 ）. LVEF increased （P 〈 0.05 ） and WMS decreased （P 〈 0.05） on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling. Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.
文摘目的探讨ST段抬高型心肌梗死(STEMI)患者,直接经皮冠状动脉介入治疗(pPCI)术后48 h内心肌血流灌注延迟时间(MFPDT)的临床价值。方法选取并分析71例已行pPCI治疗STEMI患者的临床资料,术后48 h行左心室超声造影检查,分析MFPDT与节段心肌功能(RMF)、左心室射血分数(LVEF)的相关性;依据RMF分为轻度组和严重组,比较两组间MFPDT及LVEF差异及术后平均8.5个月房室大小、LVEF、室壁瘤发生率。正态分布计量资料行t检验,计数资料行χ^(2)检验。采用多因素Logistic回归模型分析室壁瘤形成的影响因素,P<0.05为差异有统计学意义。结果术后48 hMFPDT与RMF呈正相关(r=0.5420,P<0.0001),术后48 h MFPDT与LVEF呈弱相关,与末次随访时LVEF不相关(r分别为-0.2869、-0.1950,P分别为0.0153、0.1034)。心肌受损轻度组31例,室壁瘤4例,严重组40例,室壁瘤18例,两组术后48 h MFPDT及术后室壁瘤发生率比较差异有统计学意义(χ^(2)=19.0280、8.4100,P=0.0003、0.0037),LVEF差异无统计学意义(P>0.05),术后末次随访时两组间房室大小差异无统计学意义(P>0.05)。多因素Logistic回归分析发现,MFPDT是STEMI患者短期预后的主要影响因素(OR=3.0460,P<0.0001,95%CI:1.750~5.301)。结论STEMI患者pPCI术后48 h内MFPDT可初步预测患者心肌损伤严重程度。
