Evaluation of Asynergy As an Indicator of Myocardial Fibrosis
Evaluation of Asynergy As an Indicator of Myocardial Fibrosis
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不协同作用作为心肌纤维化指标的评价
DOI：
10.1161/01.cir.57.4.715
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发表时间：
1978
期刊：
影响因子：
37.8
通讯作者：
D. Hackel
中科院分区：
文献类型：
--
作者：
R. Ideker;V. Behar;G. Wagner;J. Starr;C. Starmer;K. Lee;D. Hackel
总结24例患者心室造影中能量不齐的存在和位置与尸检中左心室纤维化的数量和位置进行了比较。通过目视检查定性和定量检测协同作用，通过用声波数字化仪-计算机系统跟踪左心室的收缩末期和舒张末期轮廓。在24例心脏中，RAO切面的定性和定量方法对72例心脏中58例（82%）的前壁、后壁和顶壁存在或不存在能量不同步的情况达成一致。在12/14例（86%）两种方法不一致的血管壁中，存在或不存在定量而非定性测定的不对称正确表明血管壁内存在或不存在纤维化。在44个含有纤维化的壁中，35个（76%）定性表现出不同步，而42个（95%）定量表现出不同步。平均纤维化随着定量测定的能量不同步的严重程度增加而增加：室壁运动正常，0.4%纤维化;运动功能减退，6.3%;运动不能，14.3%;运动障碍，30.1%。对于LAO视图，无论是定性还是定量确定的侧壁和间隔壁的能量不齐与纤维化的关系都不像RAO视图那样密切。射血分数与整个左心室的纤维化百分比呈线性相关（r = -0.88）。这项研究提供了证据，定量确定右前斜位心室造影中的不同步可以作为左心室内纤维化的指标。
SUMMARYThe presence and location of asynergy within the ventriculograms of 24 patients were compared with the quantity and site of fibrosis found in the left ventricle during postmortem examination. Asynergy was detected both qualitatively, by visual inspection, and quantitatively, by tracing end-systolic and end-diastolic outlines of the left ventricle with a sonic digitizer-computer system. The perimeters of fibrotic areas were traced during postmortem study with a sonic digitizer from photos of heart slices.For the RAO view, the qualitative and quantitative methods in the 24 hearts agreed on the presence or absence of asynergy in 58 of 72 (82%) of the anterior, posterior, and apical walls. In 12 of 14 (86%) walls in which the two methods disagreed, the presence or absence of quantitatively, but not qualitatively, determined asynergy correctly indicated the presence or absence of fibrosis within the wall. Of the 44 walls containing fibrosis, 35 (76%) demonstrated asynergy qualitatively while 42 (95%) exhibited asynergy quantitatively. Mean fibrosis increased with increasing severity of quantitatively determined asynergy: normal wall motion, 0.4% fibrosis; hypokinesis, 6.3%; akinesis, 14.3%; and dyskinesis, 30.1%. For the LAO view, neither qualitatively nor quantitatively determined asynergy in the lateral and septal walls was as closely related to fibrosis as In the RAO view. The ejection fraction was linearly correlated with the percent fibrosis of the entire left ventricle (r = -0.88).This study provides evidence that quantitatively determined asynergy in the RAO ventriculogram can serve as an indicator of fibrosis within the left ventricle.