HISTOMORPHOLOGIC CORRELATION OF NUCLEAR STUDIES

急性心肌梗死的长期预后取决于范围。 剩余和非心肌细胞的心肌细胞丢失和结构重构 左心室的肌细胞室。以评估其重要性 左侧非梗死区的结缔组织改变 我们研究了10名男性[年龄41-62岁(平均55岁)]的移植心脏。 年]患有慢性缺血性心肌病和既往心肌病 脑梗塞。已愈合的梗塞累及左侧21%+/-8%(范围9-36%) 根据形态计量学测量的心脏质量，平均值为10 左心室横断面(平均厚度8 mm)。卷 左侧圆周横切面上的胶原碎片 中腔脑室为24+/-7%(范围11-33%)，包括 替代(平均16+/-8%)和间质纤维化(平均8+/-4%)。 左侧非梗死区胶原的体积分数 缺血性心脏病患者的脑室明显增大 心肌病(平均13%)与年龄匹配的正常对照心脏 (平均值为4%，p&lt；0.01)。此外，胶原蛋白的总体积分数 左心室中段与左心室收缩功能指标的相关性 和运动核素血管造影术的舒张期功能 心脏移植前的研究(静息射血分数 (7-21%；r=-0.86；p&lt；0.05)，运动射血分数(6-23%；r=-0.86； P&lt；0.01)、达到峰值填充速率的时间(81-215毫秒；r=0.89；p&lt；0.05)，以及 收缩末期时间(266-480毫秒；r=0.83；p&lt；0.05)]。因此，非- 左心室非梗死区的肌细胞室 经历重大改建，这可能会导致减值 缺血性心脏病患者的收缩和舒张期功能 心肌病。

The long-term outcome of acute myocardial infarction depends on extent of myocyte loss and structural remodelling of remaining myocyte and non- myocyte compartments of the left ventricle. To assess the significance of connective tissue changes in the non-infarct region of the left ventricle, we studied explanted hearts of 10 men [age 41-62 (mean 55) years] with chronic ischemic cardiomyopathy and prior myocardial infarction. Healed infarct involved 21+/-8% (range 9-36%) of left ventricular mass as measured morphometrically from a mean of 10 transverse sections of the left ventricle (mean thickness 8 mm). Volume fraction of collagen in a circumferential transverse section of the left ventricle at mid-cavity was 24+/-7% (range 11-33%) and consisted of replacement (mean 16+/-8%) and interstitial fibrosis (mean 8+/-4%). Volume fraction of collagen in the non-infarct region of the left ventricle was significantly greater in patients with ischemic cardiomyopathy (mean 13%) compared to age-matched normal control hearts (mean 4%, p<0.01). Furthermore, total volume fraction of collagen in mid left ventricle correlated with indices of left ventricular systolic and diastolic function derived from exercise radionuclide angiography studies performed before cardiac transplantation [rest ejection fraction (7-21%; r=-0.86; p<0.05), exercise ejection fraction (6-23%; r=-0.86; p<0.01), time to peak filling rate (81-215 msec; r=0.89; p<0.05), and time to end-systole (266-480 msec; r=0.83; p<0.05)]. Thus, the non- myocyte compartment of the non-infarct region of the left ventricle undergoes significant remodelling which may contribute to the impairment of systolic and diastolic function in patients with ischemic cardiomyopathy.