摘要
目的 探讨经皮冠状动脉腔内成形术 (PTCA)对冬眠心肌收缩功能的近期影响。方法 对 5 3例存在节段心肌收缩功能不全的冠心病患者行超声心动图和核素心肌显像 (SPECT) ,PTCA术后1周复查超声心动图 ,比较手术前后左室整体及节段的收缩功能变化。结果 (1)术前收缩功能不全而经PTCA获得血运重建的 16 7个节段中 ,术后有 87段 (5 2 1% )功能改善 ;而未经PTCA获得血运重建的 5 9个节段中 ,术后仅有 2段 (3 4% )功能好转 (P <0 0 0 1)。血运重建区域的室壁运动指数(WMSI)从术前的 1 85± 0 96降至术后的 1 5 1± 0 80 (P <0 0 0 1) ,而非血运重建区域的WMSI在手术前后差异无显著性。 (2 )有节段收缩功能改善的患者左室射血分数 (LVEF)从术前的 5 2 1± 11 9提高至术后的 5 4 8± 11 2 (P <0 0 5 ) ,而无节段功能改善者LVEF手术前后差异无显著性 ;术后近期LVEF的提高幅度与左室整体WMSI的降低程度呈显著正相关 (r =0 73,P <0 0 0 1)。结论 成功PTCA术能在近期内改善冬眠心肌的收缩功能 ,且左室整体泵功能的变化与冬眠心肌收缩功能密切相关。
Objective To investigate the short-term effect of PTCA on contractile function of hibernating myocardium. Methods Fifty-three patients with coronary heart disease and segmental dysfunction underwent echocardiography and radionuclide imaging. Echocardiography was repeated one week after PTCA. Results (1) Recovery of contractile function occurred in 87 revascularized segments with dysfunction (87/167, 52.1%) compared with only 2 nonrevascularized segments (2/59, 3.4%) (P<0.001). The wall motion score index (WMSI) in the revascularized territories decreased from 1.85±0.96 to 1.51±0.80 (P<0.001). In contrast, there was no significant change in the WMSI in the nonrevascularized territories. (2) The left ventricular ejection fraction (LVEF) of the patients with recovered segmental function improved from 52.1±11.9 at baseline to 54.8±11.2 early after PTCA (P<0.05). In contrast, there was no significant change in LVEF in the patients without recovered segmental function. There was a positive correlation between the improved extent of LVEF and the decreased level of global WMSI (r=0.73, P<0.001). Conclusion Successful PTCA can improve contractile function of hibernating myocardium at an early stage. The improvement in global function is attributable only to functional improvement in the hibernating segments.
出处
《中国介入心脏病学杂志》
2003年第1期25-27,共3页
Chinese Journal of Interventional Cardiology
基金
广东省科委科技攻关基金资助项目 ( 982 780 3)
关键词
冠心病
经皮冠状动脉腔内成形术
冬眠心肌
收缩功能
Angioplasty, transluminal, percutaneous coronary
Myocardial hibernation
Ventricular function, left
