Estimation of Myocardial Involvement in Patients with Acute Myocardial Infarction by Two‐dimensional Echocardiography
Estimation of Myocardial Involvement in Patients with Acute Myocardial Infarction by Two‐dimensional Echocardiography
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二维超声心动图评估急性心肌梗死患者的心肌受累情况
DOI：
10.1161/01.cir.62.6.1248
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发表时间：
1980
期刊：
影响因子：
37.8
通讯作者：
C. Service
中科院分区：
文献类型：
--
作者：
J. Nixon;K. Narahara;T. Smitherman;C. Service
为了确定实时二维超声心动图是否二维超声心动图可以评估急性心肌梗死（MI）患者心肌受累的程度，分析连续短轴2-D回声记录上的局部室壁运动，并将总分与铊-201再灌注（TI）和锝-99 m焦磷酸亚锡对梗死累及的估计进行比较（99 mTc-PYP）心肌造影：研究了32名首次MI的连续男性患者; 10名患者为前壁MI，16名为下壁MI，6名为内膜下MI。2例患者在技术上不适合进行2-D超声检查。20例患者进行了TI显像，29例患者进行了99 mTc-PYP显像。2-D回波积分总和与TI估计的梗死累及密切相关（r = 0.87），与99 mTc-PYP估计的梗死面积密切相关（r = 0.74）。29例患者中，26例的2-D超声心动图MI位置与心电图位置一致; 1例下壁和2例内膜下MI出现差异。出院前二维超声未能识别透壁性梗死的范围。本研究表明，二维超声心动图是一种有效的方法，可以早期评估急性心肌梗死患者心肌受累的程度，尤其是透壁性心肌梗死。特别地，2-D回波与Tl再灌注动脉造影密切相关，因为两者都检测缺血和梗塞区域。
To determine whether real-time two-dimensional echocardiography (2-D echo) can estimate the extent of myocardial involvement in patients with acute myocardial infarction (MI), regional wall motion on serial short-axis 2-D echo recordings was analyzed and the summed scores were compared with estimates of infarct involvement by thallium-201 reperfusion (TI) and technetium-99m stannous pyrophosphate (99mTc-PYP) scintigraphy.Thirty-two consecutive male patients admitted with their first MI were studied; 10 patients had anterior, 16 had inferior and six had subendocardial MIs. Two patients were technically unsuitable for 2-D echo studies. Twenty patients had TI scintigrams and 29 had 99mTc-PYP scintigrams. Summed 2-D echo scores correlated closely with estimates of infarct involvement by TI (r = 0.87) and with estimates of infarct size by 99mTc-PYP (r = 0.74). The location of MI by 2-D echo agreed with the electrocardiographic location in 26 of 29 patients; discrepancies occurred in one inferior and two subendocardial MIs. Predischarge 2-D echo failed to identify extension of transmural infarction. However, two patients whose subendocardial MIs progressed to transmural MIs were identified.This study shows that 2-D echo is a valid method for the early estimation of the extent of myocardial involvement in patients with acute MI, especially transmural MIs. In particular, 2-D echo correlates closely with Tl reperfusion scintigraphy because both detect areas of ischemia and infarction.