Significance of Doppler-detected mitral regurgitation in acute myocardial infarction.
Significance of Doppler-detected mitral regurgitation in acute myocardial infarction.
复制标题
多普勒检测到的二尖瓣反流在急性心肌梗死中的意义。
DOI：
10.1016/0002-9149(88)90919-8
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Jaffe,AS
中科院分区：
文献类型：
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作者：
Barzilai,B;GesslerJr,C;Pérez,JE;Schaab,C;Jaffe,AS
为了确定二尖瓣反流 (MR) 的发生率并阐明其对急性心肌梗死 (AMI) 后严重充血性心力衰竭发展的潜在影响，我们在 AMI 发病后 48 小时内对 59 名患者进行了多普勒超声心动图检查。 MR 的存在是通过脉冲多普勒的心尖 4 腔和胸骨旁长轴视图来确定的。 59 名患者中有 23 名 (39%) 检测到 MR，并且在前部 AMI 患者（24 名患者中 11 名或 46%）和下壁 AMI 患者（34 名患者中 12 名或 35%）中检测到 MR。 MR 患者年龄较大（71 ± 3 岁 vs 62 ± 2 岁，p < 0.005），既往 AMI 发生率较高（23 例中有 8 例 vs 36 例中有 4 例，p < 0.05），放射性核素心室造影显示的舒张末期容积指数较大（112 ± 9 vs 72 ± 4，p < 0.005）。多普勒检测到的 23 名 MR 患者中，只有 10 名听到收缩期杂音。出现 AMI 后 8 至 14 个月确定的死亡率，患有 MR 的患者为 48%（23 名患者中的 11 名），但无 MR 患者的死亡率仅为 11%（30 名中的 4 名）（p < 0.01）。因此，本研究确定临床无症状 MR 经常使 AMI 复杂化，其存在与严重充血性心力衰竭和死亡率相关，并且是其潜在决定因素。
To define the incidence of mitral regurgitation (MR) and elucidate its potential contribution to the development of severe congestive heart failure after acute mypcardlal infarction (AMI), Doppler echocardiograms were obtained within 48 hours of onset of AMI in 59 patients. The presence of MR was determined from the apical 4-chamber and parasternal long-axis views with pulsed Doppler. MR was detected in 23 of the 59 patients (39%) and was similarly frequent in patients with anterior (11 of 24 or 46%) and inferior AMI (12 of 34 or 35%). Patients with MR were older (71 ± 3 vs 62 ± 2 years, p < 0.005), had a higher incidence of prior AMI (8 of 23 vs 4 of 36, p < 0.05) and larger end-diastolic volume indexes by radionuclide ventriculography (112 ± 9 vs 72 ± 4, p < 0.005). A systolic murmur was heard in only 10 of 23 patients with MR detected by Doppler. Mortality determined 8 to 14 months after the index AMI was 48% (11 of 23) in patients with MR but only 11% (4 of 30) in those without it (p < 0.01). Thus, this study determined that clinically silent MR frequently complicates AMI and its presence is associated with and is a potential determinant of severe congestive heart failure and mortality.