LOCATION OF AN AMI IN PATIENTS WITH A HEALED INFARCT

为了确定单个治愈的心肌梗死与 我们研究了129例致命性急性心肌梗死患者 尸检1例大体可见愈合，1例大体可见急性 并确定急性心肌梗死是否与 或邻近愈合的梗死灶，或如果一个梗死灶如此之大 它既与另一个梗死灶相对又与另一个梗死灶相邻。 在129例患者中，74例(57%)两个梗塞是相对的。 另有40人(31%)是相邻的，15人(12%)是相邻的 既相对又相邻的。治愈患者的年龄、性别、平均体型 3组心肌梗死和心脏重量相似。急性 在两者相反的组中心肌梗死更大 与其他两组比较，P&lt；0.001。 有关脑梗塞是否为临床症状的信息 108名患者可识别或未识别：两种梗死 可识别的41例(38%)，未识别的15例 (14%)，其中1个梗塞被识别，另一个未被识别 (48%)。4支主要心外膜冠状动脉的数目 在某一点上，横截面面积缩小了75% 动脉粥样硬化斑块在公认的和 在那些未被识别的脑梗塞患者中。相似数量的缩小 心外膜冠状动脉也被发现在每个 3个梗死组(对侧、相邻或两者均有)。

To determine the relation of a single healed myocardial infarct to a fatal acute myocardial infarct we studied 129 patients at necropsy with 1 grossly visible healed and 1 grossly visible acute infarct, and determined whether the acute infarct was opposite to or adjacent to the healed infarct or if one infarct was so large that it was both opposite to and adjacent to the other infarct. In 74 (57%) of the 129 patients, the 2 infarcts were opposite one another, in 40 (31%) they were adjacent, and in 15 (12%) they were both opposite and adjacent. The age, sex, mean size of the healed infarct and heart weight were similar among the 3 groups. Acute myocardial infarcts were larger in the group that had both opposite and adjacent infarcts than either of the other 2 groups (P<0.001). Information regarding whether the infarcts were clinically recognized or not was available in 108 patients: both infarcts were recognized in 41 (38%), neither infarct was recognized in 15 (14%), and 1 infarct was recognized and the other was not in 52 (48%). The number of the 4 major epicardial coronary arteries narrowed at some point >75% in cross-sectional area by atherosclerotic plaque was similar in patients with recognized and in those with unrecognized infarcts. Similar numbers of narrowed major epicardial coronary arteries also were found in each of the 3 infarct groups (opposite, adjacent or both).