Equilibrium radionuclide angiography for evaluating the effect of percutaneous coronary intervention on ventricular aneurysm formation and systolic synchrony in patients with acute myocardial infarction
Equilibrium radionuclide angiography for evaluating the effect of percutaneous coronary intervention on ventricular aneurysm formation and systolic synchrony in patients with acute myocardial infarction
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平衡核素血管造影评估经皮冠状动脉介入治疗对急性心肌梗死患者室壁瘤形成和收缩同步性的影响
DOI：
10.1007/s10554-009-9486-6
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发表时间：
2009-08
影响因子：
2.1
通讯作者：
Zhang Jing
中科院分区：
文献类型：
--
作者：
Gu Xin-Shun;Ding Chao;Hao Guo-Zhen;Jiang Yun-Fa;Xue Ling;Fan Wei-Ze;Liu Jun;Jia Xin-Wei;Wu Wei-Li;Fu Xiang-Hua;Zhang Jing
心肌梗死后左室室壁瘤（LVA）常导致严重并发症。到目前为止，LVA何时发生尚不清楚。此外，经皮冠状动脉介入治疗（PCI）是否能改变或逆转LVA的形成也是一个问题。长期随访的报道较少。因此本研究拟通过大规模连续性急性心肌梗死（AMI）患者左室造影评价LVA形成的时间顺序，并通过平衡法核素心室造影相位分析评价AMI后不同时间PCI对左室收缩同步性改变的影响。同时测定血清脑钠肽（BNP）水平，探讨其与LVA的关系。并随访3年，记录主要不良心脏事件。共326例前壁AMI合并LVA患者入选本研究。根据发病至球囊扩张时间分为4组：A组（<3 h），B组（≥3且≤6 h），C组（>6且≤12 h），D组（>1周）。分别于AMI后1周和6个月用平衡法核素心室造影测定反常容积显像、左室功能参数和收缩同步性参数。测定AMI后不同时间血浆BNP水平。主要不良心脏事件记录长达3年。AMI后6个月时，A、B、C组左室射血分数、峰值射血率、峰值充盈率均较D组显著增加，而左室相位偏移、峰值相位标准差均较D组显著降低（P均< 0.05）。AMI后6个月，A组反常容积指数低于B、C、D组（P< 0.05）。AMI后18 h、5 d、24周D组BNP水平均高于A、B、C组（P< 0.05）。B组与C组比较差异无统计学意义。随访3年，A、B、C组AMI后心绞痛发生率及病死率均明显低于D组（P< 0.05）。左室壁在急性心肌梗死后不久即可形成。早期、充分、永久性地开放梗死相关动脉可有效抑制左室重构过程，防止左室肥厚形成，改善左室功能，改善预后。
Left ventricular aneurysm (LVA) after myocardial infarction often results in serious complications. So far, when the LVA happened is unclear. Furthermore, it is a question whether percutaneous coronary intervention (PCI) can change or reverse the formation of LVA? And the report about the long term follow-up was rare. So this study was to evaluate the time sequence of the formation of LVA through left ventriculography in large scale of consecutive acute myocardial infarction (AMI) patients and evaluate the influence of PCI at different time after AMI on the change of systolic synchrony through phase analysis of equilibrium radionuclide angiography. The change of serum brain natriuretic peptide (BNP) was also measured to investigate its association with LVA. And follow up to 3 years to record the major adverse cardiac events. Total of 326 consecutive patients of anterior AMI with LVA were enrolled into this study. All patients were divided into four groups according to the time ‘onset to balloon’: group A (<3 h), group B (≥3 and ≤6 h), group C (>6 and ≤12 h) and group D (>1 week). The paradox volume image as well as the parameters of left ventricular function and systolic synchrony were measured by equilibrium radionuclide angiography at 1 week and 6th month after AMI. Plasma BNP was measured in different time after AMI. The major adverse cardiac events were recorded up to 3 years. At the 6th month after AMI, left ventricular ejection fraction, peak ejection rate and peak filling rate in group A, B and C were significantly increased than those in group D while phase shift and peak phase standard deviation were decreased significantly (P< 0.05, respectively). At 6th month after AMI, the paradox volume index in group A was lowered than that in group B, C, and D (P< 0.05, respectively). In 18th hour, 5th day and 24th week after AMI, the values of BNP in group D were higher than those in group A, B and C (P< 0.05, respectively). There was not significantly different between group B and group C. Within the 3rd year follow-up, the incidences of angina post-AMI and mortality in group A, B, and C were significantly lowered than those in group D (P< 0.05, respectively). The LVA can formate shortly after the AMI. The early, fully and permanently patency of infraction related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve its function and prognosis.
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影响因子：
2.8
作者：
Parodi, Guido;Memisha, Gentian;Antoniucci, David
通讯作者：
Antoniucci, David
DOI：
10.1161/01.cir.0000032898.55215.0d
发表时间：
2002-09
期刊：
Circulation: Journal of the American Heart Association
影响因子：
--
作者：
P. Moustakidis;H. Maniar;B. Cupps;T. Absi;Jie Zheng;J. Guccione;T. Sundt;M. Pasque
通讯作者：
P. Moustakidis;H. Maniar;B. Cupps;T. Absi;Jie Zheng;J. Guccione;T. Sundt;M. Pasque
影响因子：
37.8
作者：
Moustakidis, P;Maniar, HS;Pasque, MK
通讯作者：
Pasque, MK
影响因子：
2.8
作者：
FAXON, DP;RYAN, TJ;TONG, TGL
通讯作者：
TONG, TGL
影响因子：
3.3
作者：
A. Araszkiewicz;M. Lesiak;S. Grajek;M. Prech;A. Cieśliński
通讯作者：
A. Araszkiewicz;M. Lesiak;S. Grajek;M. Prech;A. Cieśliński