Preoperative prediction of reversible myocardial asynergy by postexercise radionuclide ventriculography.
Preoperative prediction of reversible myocardial asynergy by postexercise radionuclide ventriculography.
复制标题
通过运动后放射性核素心室造影术术前预测可逆性心肌不协同。
DOI：
--
复制
发表时间：
1982
影响因子：
158.5
通讯作者：
J. Matloff
中科院分区：
文献类型：
--
作者：
A. Rozanski;D. Berman;R. Gray;G. Diamond;M. Raymond;J. Prause;J. Maddahi;H. Swan;J. Matloff
心肌不同步有时可通过冠状动脉旁路手术逆转，一种无创性的方法来预测哪些评估是可逆的是可取的。为了评价运动后即刻观察到的心肌壁运动变化是否能区分可逆性和不可逆性心肌无力，我们对53例患者在运动前、运动后和冠脉搭桥术后静息状态下进行了核素心动图检查。运动后即刻室壁运动的术前改善对手术结果有很高的预测性(平均机会校正符合率为91%)。在手术中，运动后改善的失神经节段没有明显的心外膜疤痕。这些预测术后改善的准确性显著高于静息心电图Q波分析的准确性(P<0.01)(平均机会校正符合率为40%)。相反，术前运动后左室射血分数的变化并不能预测术后静息射血分数。我们的结论是，运动后放射性核素脑室造影术可用于识别可逆性静息心肌不律动。这项测试应该被证明是有效的，可以预测哪些心肌不同步的患者最有可能从主动脉-冠状动脉血运重建术中受益。
Myocardial asynergy is sometimes reversed by coronary bypass, and a noninvasive method of predicting which assess are reversible would be desirable. To assess whether changes in myocardial wall motion observed immediately after exercise can differentiate reversible from nonreversible myocardial asynergy, we evaluated 53 patients by radionuclide ventriculography before and after exercise and again at rest after coronary bypass surgery. Preoperative improvement in wall motion immediately after exercise was highly predictive of the surgical outcome (average chance-corrected agreement, 91 per cent). At surgery the asynergic segments that had improved after exercise were free of grossly apparent epicardial scarring. The accuracy of these predictions for postoperative improvement was significantly greater (P less than 0.01) than that of analysis of Q waves on resting electrocardiography (average chance-corrected agreement, 40 per cent). In contrast, preoperative changes in left ventricular ejection fraction after exercise were not predictive of postoperative resting ejection fraction. We conclude that postexercise radionuclide ventriculography can be used to identify reversible resting myocardial asynergy. This test should prove effective in predicting which patients with myocardial asynergy are most likely to benefit from aortocoronary revascularization.
努力限制心肌梗塞的范围。
影响因子：
39.2
作者：
Rude,RE;Muller,JE;Braunwald,E
通讯作者：
Braunwald,E