PATTERNS OF LEFT-VENTRICULAR DILATION DURING THE 6 MONTHS AFTER MYOCARDIAL-INFARCTION
PATTERNS OF LEFT-VENTRICULAR DILATION DURING THE 6 MONTHS AFTER MYOCARDIAL-INFARCTION
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DOI：
10.1016/0735-1097(89)90503-2
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发表时间：
1989-02-01
影响因子：
24
通讯作者：
HARRIS, PJ
中科院分区：
文献类型：
--
作者：
JEREMY, RW;ALLMAN, KC;HARRIS, PJ
对50例首次心肌梗塞后左室容积的变化进行了研究。在梗死后48小时、10天、1个月和6个月进行连续放射性核素血管造影，用非几何方法测量左心室容积。左心室扩张（≥舒张末期容积增加20%）发生在11名患者的梗塞10天内，这些患者的平均容积增加为34 ± 1.5。10天时为15%（p=0.002 vs 48 h），61 . ±. 6个月时为43%（p=0.01 vs 10天）。另外10名患者在10天至6个月之间表现出左心室扩张，容积增加较小，为42 ± 1.5。18%，6个月。在21例心室扩张的患者中，进行性扩张（连续体积增加≥ 100%）。20%发生在两个或两个以上的场合）发生在8例患者，谁都有一个大的前梗死。第10天、第1个月和第6个月的平均体积增加为27 ± 0.5%。20%，49 . ±. 40%（p=0.03 vs 10天）和79 . ±. 37%（p=0.006 vs 1个月）。在进行性扩张的患者中，左心室射血分数从35 . ±. 48 h至24 ±-时为6%。1个月时为10%（p < 0.001），27 . ±. 6个月时为10%（p=0.006）。梗死后1个月至2年，6例患者死亡，其中4例进行性扩张。严重的左心室扩张可在梗死后的前10天内发生，并可能在接下来的6个月内进展，心室功能恶化，死亡的可能性很高。
Changes in left ventricular volume after a first myocardial infarction were studied in 50 patients. Serial radionuclide angiograms were obtained 48 h, 10 days and 1 and 6 months after infarction and left ventricular volume measured by a nongeometric method. Left ventricular dilation (.gtoreq. 20% increase in end-diastolic volume) occurred within 10 days of infarction in 11 patients, who had a mean volume increase of 34 .+-. 15% ( p=0.002 versus 48 h) at 10 days and 61 .+-. 43% (p=0.01 versus 10 days) at 6 months. Ten other patients manifested left ventricular dilation between 10 days and 6 months with a lesser volume increase of 42 .+-. 18% by 6 months. Among the 21 patients with ventricular dilation, progressive dilation (serial volume increases .gtoreq. 20% on two or more occasions) occurred in 8 patients, who all had a large anterior infarct. Mean volume increases at 10 days and 1 and 6 months were 27 .+-. 20%, 49 .+-. 40% (p=0.03 versus 10 days) and 79 .+-. 37% (p=0.006 versus 1 month), respectively, in this group. In patients with progressive dilation, left ventricular ejection fraction decreased from 35 .+-. 6% at 48 h to 24 .+-. 10% at 1 month (p < 0.001) and 27 .+-. 10% (p=0.006) at 6 months. Between 1 month and 2 years after infarction six patients died, of whom four had progressive dilation. Severe left ventricular dilation can develop within the first 10 days after infarct in and may progress during the next 6 months, with deterioration in ventricular function and a high likelihood of death.