CROSS-SECTIONAL ECHOCARDIOGRAPHY IN ACUTE MYOCARDIAL-INFARCTION - DETECTION AND LOCALIZATION OF REGIONAL LEFT-VENTRICULAR ASYNERGY
CROSS-SECTIONAL ECHOCARDIOGRAPHY IN ACUTE MYOCARDIAL-INFARCTION - DETECTION AND LOCALIZATION OF REGIONAL LEFT-VENTRICULAR ASYNERGY
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DOI：
10.1161/01.cir.60.3.531
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发表时间：
1979-01-01
期刊：
影响因子：
37.8
通讯作者：
FEIGENBAUM, H
中科院分区：
文献类型：
--
作者：
HEGER, JJ;WEYMAN, AE;FEIGENBAUM, H
采用横断面超声心动图评价急性心肌梗死相关的左室不同步。急性梗死患者入院后48小时内进行了研究，并进行了节段性分析的左室壁运动，使用9段获得的短轴和长轴记录的左室。通过这种节段性方法，可以分析整个左心室的室壁运动。在44例原始患者中，有37例记录了完整的研究。在37例研究患者中记录并定位节段性室壁运动异常。共发现142个节段无协同，29例多节段受累。无协同作用是最常见的心尖段的左心室，但横截面扫描允许检测所有节段的不同步。心电图与横断面超声心动图对比显示，下壁梗死20例中19例为后段运动不协调，前壁梗死14例中14例为前段运动不协调，前壁梗死3例中3例为前后段运动不协调。此外，节段性能量不齐的位置遵循每个梗死ECG亚组的特定模式。在4例尸检患者中，22个节段中的21个节段在横断面超声心动图上显示不对称，同时也有梗死的病理证据。横断面超声心动图提供了一种可靠的方法来检测与急性心肌梗死相关的区域性能量不同步的存在和位置。
Left ventricular asynergy associated with acute myocardial infarction was evaluated by cross-sectional echocardiography. Patients with acute infarction were studied within 48 h of admission, and a segmental analysis of left ventricular wall motion was performed using 9 segments obtained by short- and long-axis recordings of the left ventricle. By this segmental approach, analysis of wall motion in the entire left ventricle was possible. Complete studies were recorded in 37 of 44 original patients. Segmental wall motion abnormalities were recorded and localized in each of the 37 study patients. Asynergy was detected in 142 segments and 29 patients had multiple segment involvement. Asynergy was most common in the apical segments of the left ventricle, but the cross-sectional scans permitted detection of asynergy in all segments. Correlation between the ECG and the cross-sectional echocardiogram revealed that 19 of 20 patients with inferior infarction had asynergy in posterior segments, 14 of 14 patients with anterior infarction had asynergy in anterior segments and 3 of 3 patients with anteroinferior infarction had asynergy in both anterior and posterior segments. In addition, the location of segmental asynergy followed specific patterns for each ECG subgroup of infarction. In 4 patients with postmortem examination, 21 of 22 segments that had asynergy by cross-sectional echocardiography also had pathologic evidence of infarction. The cross-sectional echocardiogram provides a reliable method for detecting the presence and location of regional asynergy associated with acute myocardial infarction.