Characteristic clinical findings of reversible left ventricular dysfunction.
Characteristic clinical findings of reversible left ventricular dysfunction.
复制标题
可逆性左心室功能障碍的特征性临床表现。
DOI：
10.2169/internalmedicine.41.789
复制
发表时间：
2002
影响因子：
1.2
通讯作者：
S. Kohno
中科院分区：
文献类型：
--
作者：
T. Yamasa;S. Ikeda;A. Ninomiya;T. Yoshinaga;S. Hata;K. Yakabe;M. Fukahori;Y. Miyahara;S. Kohno
目的
在这项研究中，16例可逆性左心室功能不全（RLVD）患者的临床表现进行了评价，这些患者的临床表现与急性心肌梗死相似，除了左心室心尖部运动不能或运动障碍外，没有显示任何冠状动脉异常。
结果
在这16例患者中，女性RLVD的发生率明显高于男性（男性：女性= 1：7）。此外，这些患者的心电图变化与缺血性心脏病相似，如ST段抬高或压低、负T波和QT间期延长。然而，血清心脏标志物仅略有增加，心肌组织学检查未检测到特异性变化。
结论
这些患者也表现出类似于心肌缺血引起的顿抑心肌的临床表现。然而，与其他冠状动脉疾病的发生率相比，女性RLVD的发生率高于男性，并且冠状动脉没有严重狭窄。此外，大多数患者的冠状动脉痉挛激发试验结果为阴性。因此，如果RLVD是由冠状动脉粥样硬化引起的，那么它可能是一种不典型的缺血性心脏病。由于RLVD是在其他疾病的过程中或在严重的精神压力下发生的，因此自主神经可能参与了RLVD的病因学。此外，2例在急性期接受冠状动脉痉挛激发试验的患者显示阳性结果。因此，短暂增加冠状动脉敏感性的其他因素也可能参与RLVD的病因学。
OBJECTIVE
In this study, clinical findings were evaluated in 16 patients with reversible left ventricular dysfunction (RLVD) who showed a clinical picture similar to that of acute myocardial infarction, in addition to akinesis or dyskinesis of the left ventricular apex without showing any abnormalities in the coronary artery.
RESULTS
The frequency of RLVD was markedly higher in women than in men in these 16 patients (men:women = 1:7). In addition, these patients showed ECG changes similar to those observed in ischemic heart diseases, such as ST elevation or depression, negative T waves and QT prolongation. However, the serum cardiac markers were only slightly increased, and no specific changes were detected by histological examinations of the heart muscle.
CONCLUSION
These patients also showed a clinical picture similar to the stunned myocardium caused by myocardial ischemia. However, the frequency of RLVD was higher in women than in men compared to the frequency of other coronary artery diseases, and there was no severe stenosis in the coronary artery. Moreover, most of these patients showed negative results for the coronary spasm provocation test. Therefore, RLVD may be an atypical ischemic heart disease if it is caused by coronary arteriosclerosis. Since RLVD developed during the course of other diseases or under severe mental stress, autonomic nerves may be involved in the etiology of RLVD. Furthermore, 2 patients who received the coronary spasm provocation test during the acute phase showed positive results. Therefore, other factors that transiently increase the sensitivity of the coronary artery may also be involved in the etiology of RLVD.