【摘要】 目的应用经胸冠脉血流显像(TCFDI)技术定量评价梗死前心绞痛(PA)对冠脉内皮功能的影响。方法根据有无PA将首次急性心肌梗死(AMI)的31例患者分为两组,有PA组和无PA组。患者入院当天行常规心脏超声检查记录室壁运动记分指数(WMSI)。住院期间行TCFDI,小剂量多巴酚丁胺负荷超声心动图(LDSE)。AMI后3个月再次行心脏超声检查评价WMSI。结果无PA组15例中12例(80%)CFR减低(≤2.5),而PA组16例中仅有3例CFR减低(19%,P<0.05)。CFR值无PA组显著低于PA组(P<0.0001)。AMI初诊当天WMSI两组间无显著性差异,然而LDSE结果及AMI3个月后常规超声显示PA组WMSI改善程度优于无PA组。结论梗死前心绞痛能够保护心肌的冠脉循环功能,利于再血管化后左室功能恢复。更多还原

【Abstract】 Objective To objectively evaluate the effect of preinfarction angina (PA) on coronary endothelial function by transthoracic coronary flow Doppler imaging (TCFDI).Methods In 31 patients with a first acute myocardial infarction,we assessed coronary flow reserve (CFR:Vmax/Vbase,VTImax/VTIbase) with intravenous adenosine[140 μg/(kg·min)for 5 min] on TCFDI.Low-dose dobutamine stress echocardiography (LDSE) and 3-month follow-up echocardiography were performed and wall motion score index (WMSI) was evaluated. Results Typical angina was present in 16 patients (PA group) and absent in 15 patients (No-PA group) during the 7 days preceding the myocardial infarction.Compared with the two groups,the PA group showed a greater CFR than that in the Non-PA group (P<0.0001).The patients with PA had a better regional myocardial function expressed with WMSI at LDSE and at follow-up echocardiography,but at MI initial visit day,the WMSI in the two groups were no significant difference.Conclusions Preinfarction angina can effectively protect CFR assessed by TCFDI and is beneficial for the recovery of left ventricular function after revascularization.更多还原