心肌带收缩率与急性心肌梗死患者左心室收缩功能关系

目的:急性前壁心肌梗死明显影响室间隔收缩率和左心室射血分数(left ventricular ejection fraction LVEF)。本文旨在探讨心肌带降段及升段收缩率与急性前壁心肌梗死患者LVEF的相关性。方法:收集2015年4月-2017年2月在心内科住院的急性前壁心肌梗死患者36例,正常对照组患者39例。所有患者取左心室长轴M型超声心动图,测量室间隔收缩率、升段收缩率及降段收缩率。心肌梗死左心室射血分数采用双平面Simpson's法计算。结果:与正常对照组相比,心肌梗死组患者舒张末期心肌带升段厚度没有统计学差异(P=0.69),收缩末期升段厚度(P=0.014)更薄、升段收缩率(P0.01)明显降低;心肌梗死组舒张末期降段厚度(P0.01)更薄、收缩末期降段厚度(P0.01)更薄、降段收缩率(P0.01)明显降低;心肌梗死组左心室射血分数与降段收缩率(r~2=0.13,P=0.026)、室间隔增厚率(r~2=0.19,P0.01)呈正相关,与升段收缩率没有相关性(P0.05)。正常对照组左心室射血分数与室间隔增厚率、降段增厚率及升段增厚率无相关性。经过相关分析,筛选出与心肌梗死LVEF的相关因素,进一步经逐步回归分析,得多元线性回归方程为LVEF=48.206+18.914*LVDD(cm)-25.414*LVSD(cm)。结论:急性前壁心肌梗死室间隔降段收缩率明显受损,与左心室射血分数降低有关。多元线性回归方程可估算前壁心肌梗死LVEF。

Assessment of Ventricular Myocardial Band and Left Ventricular Systolic Function in Acute Myocardial infarction Patients

ABSTRACT Objective: Acute anterior myocardial infarction obviously influence the thickening rate of myocardial septum and left ventricular ejection fraction (LVEF). The purpose of this study was to investigate the value of descending and ascending segments thickening rate of helical ventricular myocardial band in the evaluation of left ventricular ejection fraction in acute anterior myocardial infarction patients. Methods: 36 acute anterior myocardial infarction patients and 39 normal patients were involved in during 2015.04-2017.02. The ascending and descending segments were identified by echogenic bright line in M mode in the ventricular septum. The LVEF of acute anterior myocardial infarction patients were measured by Simpson''s method. Results: There was no statistical difference in end diastolic ascending segments length (P=0.69) between myocardial infarction group and control group. However, the end systolic ascending segments length(P=0.014), ascending segments thickening rate(P<0.01), the end diastolic descending segments length(P<0.01), the end systolic descending segments length(P<0.01), descending segments thickening rate(P<0.01) in myocardial infarction group were significantly lower than the control group. Left ventricular ejection fraction had positive correlation with descending segments thickening rate (r²=0.13, P=0.026) and interventricular septum thickening rate (r²=0.19, P<0.01), but not with ascending segments thickening rate (P>0.05). While there had no correlation between left ventricular ejection fraction and descending segments thickening rate, ascending segments thickening rate and interventricular septum thickening rate in control group. The model of LVEF prediction was scores of LVEF= 48.206+18.914*LVDD(cm)-25.414*LVSD(cm). Conclusion: Left ventricular descending segments thickening rate significantly injured in acute anterior myocardial infarction, which have correlation with left ventricular ejection fraction decreased. The model of LVEF prediction can estimate the LVEF of myocardial infarcton.