Serial Evaluation of Myocardial Thickening and Thinning in Acute Experimental Infarction: Identification and Quantification Using Two‐dimensional Echocardiography
Serial Evaluation of Myocardial Thickening and Thinning in Acute Experimental Infarction: Identification and Quantification Using Two‐dimensional Echocardiography
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急性实验性梗塞中心肌增厚和变薄的系列评估：使用二维超声心动图进行识别和量化
DOI：
10.1161/01.cir.66.1.174
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发表时间：
1982
期刊：
影响因子：
37.8
通讯作者：
R. Kloner
中科院分区：
文献类型：
--
作者：
M. Nieminen;A. Parisi;J. E. O'Boyle;E. Folland;S. Khuri;R. Kloner
采用定量二维超声心动图（2-D echo）对20只左冠状动脉前降支结扎术后犬的局部左心室功能进行了连续研究。选取20只健康犬，建立局部心肌增厚正常值，作为识别异常收缩节段（ACS）的标准。正常心脏增厚率从基部（25.8%）到心尖（34.0%）呈增加趋势，但各节段间差异较大（20.0 ~ 40.0%）；然而，每个节段至少有一定程度的增厚。冠状动脉闭塞后，心肌节段变薄或未增厚。在乳头肌水平，2 - 48小时功能改善，2小时变薄，48小时增厚。48小时组织梗死面积（IS）与2小时、24小时和48小时ACS加权总和得出的IS相关。2小时时，ACS明显高估且与组织IS相关性较差（25.3% vs 13.4%; r = 0.60）；48 h时，ACS预测IS下降至15.3% (p < 0.05)，与组织IS有改善，但与组织IS相关性较好（r = 0.73, SEE = 4.9%）。我们得出结论，二维回波对心肌增厚有相当大的异质性，但在正常狗心脏中未见增厚失败。在许多狗中，冠脉结扎术后2小时心肌功能障碍的程度超过了后来看到的程度。组织IS很难从ACS中准确预测。由于急性心肌梗死中肌肉功能障碍的数量并不一定等同于组织坏死的数量，因此ACS可能更适合用于跟踪梗死的进程，而不是预测is。
Regional left ventricular function was studied serially by quantitative two-dimensional echocardiography (2-D echo) in 20 dogs after left anterior descending coronary artery ligation. Normal values for regional myocardial thickening were established in 20 healthy dogs and used as a standard to recognize abnormally contracting segments (ACS). In normal hearts, the mean percent thickening tended to increase from base (25.8%) to apex (34.0%), but showed considerable diversity from segment to segment (range 20.0-40.0%); nevertheless, at least some degree of thickening was seen in every segment. After coronary occlusion, myocardial segments either thinned or failed to thicken. At the papillary muscle level, there was an improvement in function between 2 and 48 hours, with thinning at 2 hours and thickening at 48 hours. Tissue infarct size (IS) determined at 48 hours was related to IS derived from a weighted summation of ACS at 2, 24 and 48 hours. At 2 hours, ACS considerably overpredicted and correlated poorly with tissue IS (25.3% vs 13.4%; r = 0.60); by 48 hours, IS predicted by ACS had decreased to 15.3% (p < 0.05) and had an improved, but only fair correlation with tissue IS (r = 0.73, SEE = 4.9%).We conclude that there is considerable heterogeneity to myocardial thickening by 2-D echo, but failure to thicken is not seen in the normal dog heart. In many dogs, the extent of myocardial dysfunction 2 hours after coronary ligation exceeds that seen later. Tissue IS is difficult to predict accurately from ACS. Since the amount of muscle dysfunction is not necessarily equivalent to the amount of tissue necrosis in acute myocardial infarction, ACS may be more appropriately used to track the course of infarction rather than to predict IS.