螺内酯抑制急性前壁心肌梗死患者的左室重构

目的探讨急性前壁心肌梗死患者口服螺内酯对于左室重构的影响。方法将急性前壁心肌梗死患者随机分为两组。对照组30例,接受血管紧张素转换酶抑制剂、β-受体阻滞剂、抗血小板、调脂药物等常规处理。螺内酯组30例,在常规治疗基础上加用螺内酯（40mg,每日1次）。随访1年,并检测脑钠尿肽（BNP）及超声心动图以评价左室功能和左室容积。结果6和12月时螺内酯组血清BNP水平明显低于对照组[（355±74）ng/Lvs（418±77）ng/L,P<0.05和（316±72）ng/Lvs（389±67）ng/L,P<0.05],且12月时螺内酯组较对照组左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）明显缩小[LVEDD:（49±6）mmvs（53±5）mm,P<0.05;LVESD:（37±5）mmvs（40±4）mm,P<0.05]。结论螺内酯可抑制急性前壁心肌梗死患者左室重构。     

急性心肌梗死与左室重构

急性心肌梗死(AMI)后左室发生细胞学,分子学及细胞间质的变化,进而引起左室在大小、形态、组织结构和功能状态的改变,此即目前许多研究所提及的AMI后的左室重构.AMI后左室的重构贯穿于整个病程的始终,成为影响AMI患者近远期预后的主要原因之一.     

Effect of hepatocyte growth factor on left ventricular remodeling after acute myocardial infarction in canine

Background and objectives To investigate the effect of hepatocyte growth factor (HGF) on left ventricular (LV) remodeling after acute myocardial infarction (AMI). Methods AMI was produced by ligation of proximal left anterior descending coronary artery(LAD) in 12 mongrel canines. These animals were randomized into 2 groups. In HGF group (n=6), canines were injected with pcDNA3-HGF lml (about 300ug) at the margin of infarcted myocardium; in control group (n=6) canines were injected with equal volume of normal saline. Cardiac function and left ventricular remodeling were evaluated with echocardiography at 1, 4, 8 weeks after MI. LV myocardium specimens were obtained at 8 weeks and stained with hematoxylin and eosin for histological examination or with sirius red to assess the collagen content. Results Compared with control group, LVEF in HGF group was significantly higher at 4 weeks (49.61+6.66 vs 39.84+6.39; P＜0.05) and at 8 weeks (51.57+8.53 vs 40.61+7.67; P＜0.05) after AMI, while LVESV was significantly lower in HGF group than that in control group at 8 weeks after AMI (18.98+3.47 vs 25.66+5.86; P＜0.05). Posterior left ventricular wall thickness decreased significantly from 1 wk to 8 wks after AMI in control group, while remained unchanged in HGF group. Compared with control group, histological examination showed more neovascularization and less scar, and sirius red staining indicated higher volume of type Ⅲ collagen (7.10&#177;4.06% vs 3.77&#177;1.09%; P＜0.05) and lower collagen Ⅰ/Ⅲ ratio value (1.11&#177;0.52 vs 2.94&#177;2.48; P＜0.05)in HGF group. Conclusion HGF gene transfer might improve cardiac function and LV remodeling after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, and reducing myocardial scarring.     

Early mitral regurgitation after acute myocardial infarction does not contribute to subsequent left ventricular remodeling

BACKGROUND: It is well known that mitral regurgitation may lead to left ventricular dilation; however, the relationship between progressive left ventricular dilation after acute myocardial infarction (MI) and mitral regurgitation has not yet been clarified. HYPOTHESIS: This study tested the hypothesis that early mitral regurgitation contributes to left ventricular remodeling after acute MI. METHODS: We prospectively evaluated 131 consecutive patients by serial two-dimensional and Doppler echocardiography on Days 1, 2, 3, and 7, after 3 and 6 weeks, 3 and 6 months, and 1 year following acute MI. Patients were divided into two groups: those with mitral regurgitation in the first week after acute MI (Group 1, n = 34) and those without mitral regurgitation (Group 2, n = 81). RESULTS: Over 1 year, a significant increase in end-diastolic volume index (from 62.1 +/- 12.9 to 70.5 +/- 23.6 ml/m2, p = 0.001) with a strong linear trend (F = 15.1, p < 0.001) was noted. Initial end-diastolic volume index was higher in Group 1 (65.6 +/- 13.3 vs. 60.4 +/- 12.5 ml/m2, p = 0.047), but this difference remained constant throughout the study (F = 1.76, p = NS). Therefore, the pattern of end-diastolic volume changes was similar in both groups during the period of observation. CONCLUSIONS: These data indicate that early mitral regurgitation after acute MI does not contribute to subsequent left ventricular remodeling in the first year after myocardial infarction.     

急性心肌梗死后左室重构临床研究

目的　探讨溶栓治疗对急性心肌梗死后左室结构和功能的影响。方法　对 36例首发急性心肌梗死患者于梗死后 4周和 12周进行超声心动图观察。分别测定左室舒张末期容积指数 (LVEDVI)、左室收缩末期容积指数 (LVESVI)、射血分数 (EF) ,作为反映左室结构和功能变化的指标。结果　急性心肌梗死后LVEDVI、LVESVI均明显增高 (分别为P <0 0 1,P <0 0 5 )。 4周和 12周检查发现 ,溶栓组LVEDVI、LVESVI无明显差异 (分别P>0 0 5 ,P >0 0 5 ) ,EF值明显增大 (P <0 0 5 ) ;未溶栓组LVEDVI、LVESVI明显增大 (分别为P <0 0 5 ,P <0 0 5 ) ,EF值无明显变化 (P >0 0 5 ) ;对 4周和 12周的检查结果作组间比较发现 ,溶栓组LVEDVI、LVESVI均小于未溶栓组 (P <0 0 5 ) ,EF值溶栓组高于未溶栓组 (P <0 0 5 )。结论　溶栓治疗能有效地抑制急性心肌梗死后左室重构 ,改善心功能。     

EflFect of hepatocyte growth factor on left ventricular remodeling after acute myocardial infarction in canine

Background and objectives To investigate the effect of hepatocyte growth factor (HGF) on left ventricular (LV) remodeling after acute myocardial infarction (AMI). Methods AMI was produced by ligation of proximal left anterior descending coronary artery (LAD) in 12 mongrel canines. These animals were randomized into 2 groups. In HGF group (n=6), canines were injected with pc-DNA3-HGF 1 ml (about 300ug) at the margin of infarcted myocardium; in control group (n=6) canines were injected with equal volume of normal saline. Cardiac function and left ventricular remodeling were evaluated with echocardiography at 1,4, 8 weeks after MI. LV myocardium specimens were obtained at 8 weeks and stained with hematoxylin and eosin for histological examination or with sirius red to assess the collagen content. Results Compared with control group, LVEF in HGF group was significantly higher at 4 weeks (49.61 6.66 vs 39.84 6.39; P<0.05) and at 8 weeks (51.57 8.53 vs 40.61 7.67; P<0.05) after AMI, while LVESV was significantly lower in HGF group than that in control group at 8 weeks after AMI (18.98 3.47 vs 25.66 5.86; P<0.05). Posterior left ventricular wall thickness decreased significantly from 1 wk to 8 wks after AMI in control group, while remained unchanged in HGF group.Compared with control group, histological examination showed more neovascularization and less scar, and sirius red staining indicated higher volume of typeⅢcollagen (7.10±4.06% vs 3.77±1.09%; P<0.05) and lower collagenⅠ/Ⅲratio value (1.11±0.52 vs 2.94±2.48; P<0.05) in HGF group. Conclusion HGF gene transfer might improve cardiac function and LV remodeling after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, and reducing myocardial scarring.     

急性心肌梗死患者早期血浆脑钠素与左室重塑的关系

目的　探讨急性心肌梗死 (AMI)早期血浆脑钠素与左室重塑的关系。方法　 44例AMI患者分为依那普利组及常规治疗组 ,采用放射免疫法测定入院后 14d内血浆脑钠素水平 ;超声心动图测定同期及 3个月左室舒张末容积指数 (LVEDVI)、左室收缩末容积指数 (LVESVI)及左室射血分数 (LVEF)。结果　常规治疗组入院后即刻血浆脑钠素水平较健康对照组明显升高 (P <0 .0 1) ,5、14d较入院即刻进一步升高 (P <0 .0 5 )。AMI患者 5、14d血浆脑钠素水平与同期及 3个月LVEDVI、LVESVI正相关 (P <0 .0 5 ,0 .0 1)。与常规治疗组相比 ,依那普利组脑钠素与心室容积指数一致性下降。结论　AMI后早期血浆脑钠素升高与左室重塑密切相关。     

急性前壁心肌梗死后梗死相关血管延迟开通对晚期左室重构的影响

目的探讨急性前壁心肌梗死后,延迟经皮冠状动脉血运重建术(PCI)使梗死相关血管(IRA)开通,对心梗晚期左室重构的影响.方法选择64例急性前壁、前间壁及广泛前壁Q波性心梗后病情稳定,发病10～21天冠脉造影证实左前降支完全闭塞者,依据是否接受成功PCI,分为成功PCI组和对照组,分别于急性期、术后2个月和6个月应用超声心动图随访左室腔大小、左室功能和室壁活动异常,并观察6个月期间心力衰竭事件的发生情况.结果心梗后2个月两组左室射血分数(LVEF)、左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)和室壁活动异常(VWMA)积分与急性期相比无明显差异(P＞0.05),急性期和2个月时两组上述各指标之间相比差异也无显著性(均P＞0.05).6个月时两组LVEF和VWMA积分与急性期和2个月相比无明显差异(P＞0.05),但对照组LVEDVI和LVESVI较急性期明显增大(P＜0.01,P＜0.05),且与成功PCI组相比差异具有显著性(P＜0.01,P＜0.05).6个月随访期间心力衰竭事件发生率对照组为19%,成功PCI组2%,但差异缺乏统计学意义(P＞0.05).结论急性前壁心梗后IRA延迟开通能明显减少心梗后晚期的左室重构,而对心梗后早期左室重构的影响不大.延迟PCI可能有利于减少心梗后远期心力衰竭事件的发生.     

肝细胞生长因子对急性心肌梗死后左室重构的预测作用

目的: 探讨血清肝细胞生成因子(HGF)对急性心肌梗死(AMI)后早期左室重构的预测价值。方法: 36例AMI患者入院时及发病7 d测定血清HGF水平;AMI其中的26例分别于发病后7~10 d及发病后3个月行超声心动图检查,3个月时左室舒张末期容积指数（LVEDVI）与7~10 d时比增加≥5 ml/m2定义为左室重构组(n=11),对两组血清HGF值进行比较。结果: AMI患者入院时血清HGF浓度较对照组明显升高［(809±288)ng/L vs.(620±162)ng/L,P<0.01］,7 d时升高更显著［(1 607±1 355)ng/L,P<0.01］。发病7 d时血清HGF浓度在左室重构组较非左室重构组升高［(2 216±1 522)ng/L vs.(1 176±593)ng/L,P<0.05］,而入院时两组浓度则无显著差异。结论: AMI时血清HGF浓度升高,AMI后7 d时增高的血清HGF可能预示心室重构。     

急性心肌梗死经皮冠状动脉介入治疗患者心肌胶原与左心室重构的关系

目的探讨急性心肌梗死经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗患者心肌胶原变化与左心室重构关系。方法选择2011年12月至2012年9月入住宝安区人民医院的急性心肌梗死患者共70例为研究对象。按照入院后患者是否行直接PCI治疗分为直接PCI治疗组(n=30)和择期PCI治疗组(n=30),其中10例(其中直接PCI治疗组5例,择期PCI治疗组5例)患者出院后不愿意随访。所有入选患者术前、术后3 d及术后30 d均分别以酶联免疫吸附法测定血清Ⅰ型C端胶原前肽(carboxy-terminal propeptide of type I procollagen,PICP)、Ⅲ型N端胶原前肽(amino-terminal propeptide of type III procollagen,PⅢNP)和Ⅰ型C端胶原末肽(carboxy-terminal telopeptide of collagen type I,CITP)浓度;术后3 d、术后30 d均行心脏超声检查;术后30 d行单光子发射计算机断层显像测量心肌梗死面积。结果术后30 d直接PCI治疗组血清PICP、PⅢNP、CITP浓度较择期PCI治疗组明显降低,差异有统计学意义[PICP:(7.76±1.47)ng/mL vs.(10.73±1.67)ng/mL,P﹤0.05;PⅢNP:(11.17±4.72)ng/mL vs.(37.80±6.83)ng/mL,P﹤0.05;CITP:(31.18±6.78)ng/mL vs.(45.10±9.70)ng/mL,P﹤0.05]。术后30 d直接PCI治疗的左心室舒张末期内径、左心室收缩末期内径、心肌梗死面积明显低于择期PCI治疗组[(46.57±6.10)mm vs.(52.63±6.50)mm,P﹤0.05;(34.25±4.86)mm vs.(37.33±3.56)mm,P﹤0.05;22.8%±3.4%vs.28.2%±6.8%,P﹤0.05]。结论直接PCI治疗可有效地挽救濒死的心肌,减轻心室重构,保护心功能,改善患者远期预后。检测血清心肌胶原浓度能作为预测心室重构的指标。     

Spontaneous recovery of left ventricular function following acute anterior myocardial infarction

Four patients with acute anterior wall myocardial infarction showing spontaneous and marked improvement in systolic left ventricular function are described. All 4 patients showed abnormal Q waves and severe wall motion abnormalities soon after acute infarction. In all 4 patients, at least some regeneration of R-wave forces occurred and the regional wall motion in the involved area of the left ventricle improved dramatically without coronary angioplasty or surgical revascularization during the intervening period. The improvement in left ventricular function was attributed to spontaneous increase in nutrient flow to the involved area. It is concluded that Q waves and severe wall motion abnormalities do not necessarily indicate irreversible scar formation.     

冠状动脉介入治疗再灌注时间对急性前壁心肌梗死左室重构及远期预后的影响

目的评价冠状动脉介入治疗(PCI)再灌注时间对急性前壁心肌梗死左室重构及远期预后的影响。方法选择113例首次急性前壁心肌梗死患者,冠状动脉造影证实梗死相关动脉(IRA)完全闭塞(TIMI0～1级)。依据PCI再灌注时间分为3组,A组35例,6h内IRA成功再灌注;B组40例,6～12h内IRA成功再灌注;C组38例,12～24h内IRA成功再灌注。分别于术后即刻和6个月行冠状动脉造影及左心室造影,对比分析3组左心室造影的心功能指标:左心室舒张末容积、左心室收缩末容积、左心室射血分数、每分输出量、心脏指数,并观察1年内主要不良心脏事件(MACE)的发生情况。结果成功再灌注即刻,3组之间各项心功能参数无显著性差异。6个月时A组和B组各项心功能参数较即刻有改善趋势;C组较前下降,但均无统计学意义。1年随访期间,A、B组无死亡及再次心肌梗死事件发生。心绞痛的发生在3组中无差别。C组心力衰竭及死亡的发生均明显高于A、B组。结论前壁心肌梗死后尽早行PCI,开通IRA,可阻抑左室重构,改善心功能,减少死亡等MACE的发生,从而改善预后。     

梗死相关血管晚期开通对急性心肌梗死后左室功能的影响

目的探讨急性前壁心肌梗死后延迟经皮冠状动脉血运重建术(PCI)使梗死相关血管(IRA)开通对心梗晚期左室功能的影响。方法选择64例急性前壁、前间壁及广泛前壁Q波性心梗后病情稳定,发病10～21d冠脉造影证实左前降支完全闭塞者,依据是否接受成功PCI,分为成功PCI组和对照组,分别于急性期、术后2个月和6个月应用超声心动图随访左室腔大小、左室功能和室壁活动异常,并观察6个月期间心力衰竭事件的发生情况。结果心梗后2个月两组左室射血分数(LVEF)、左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)和室壁活动异常(VWMA)积分与急性期相比无明显差异(P>0.05),急性期和2个月时两组上述各指标之间相比差异也无显著性(均P>0.05)。6个月时两组LVEF和VWMA积分与急性期和2个月相比无明显差异(P>0.05),但对照组LVEDVI和LVESVI较急性期明显增大(P<0.01,P<0.05),且与成功PCI组相比差异具有显著性(P<0.01,P<0.05)。6个月随访期间心力衰竭事件发生率对照组为19%,成功PCI组2%,但差异缺乏统计学意义(P>0.05)。结论急性前壁心梗后IRA延迟开通能明显减少心梗后晚期的左室重构,而对心梗后早期左室重构的影响不大。延迟PCI可能有利于减少心梗后远期心力衰竭事件的发生。     

血管紧张素转化酶基因多态性与急性前壁心梗后患者左心室重塑及预后的相关性研究

目的 探讨血管紧张素转化酶(ACE)基因多态性与急性前壁心梗后患者左心室重塑及预后的关系。方法 选取164例急性前壁心肌梗死(AMI)患者作为研究对象。超声检测患者左心室收缩末期内径(LVSD)、左心室舒张末期内径(LVDD)、左室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、心肌做功指数(MPI)等指标。提取所有患者外周血DNA,多聚酶链反应检测ACE插入(I)/缺失(D)多态性。对所有患者随访1年,记录主要心血管事件(MACE)发生情况。比较不同ACE基因型与左室重塑及1年内MACE发生频率的关系。结果 164例AMI患者ACE基因I/I型80例、D/D 型67例、I/D型17例,分布频率分别为48.8%、40.8%、10.4%。第7天时,三组患者MPI、LVEDV、LVESV和LVSD差异有统计学意义(P＜0.05)。D/D基因型组患者第7 天MPI、LVESV、LVDD较第1天时显著下降,而LVEDV、LVEF较第1天显著升高(P＜0.05)。I/D基因型组患者第7 天MPI和LVEF与第1天时差异具有统计学意义(P＜0.05)。D/D基因型患者发生MACE的风险显著增加,其OR值为17.16,而I/I基因型患者发生MACE的风险显著下降,其OR值仅为0.39(P<0.05)。结论 ACE基因多态性可能会影响早期心肌梗死后重塑,而D/D型更易发生左室重塑并且1年内发生MACE的风险显著高于其余两种基因型。     

微小剂量卡维地洛防治大鼠急性心肌梗死左室重构的实验研究

目的　探讨微小剂量卡维地洛对大鼠急性心肌梗死 (AMI)左室重构的防治作用。方法　采用Olivetti的方法对 130只雌性SD大鼠致AMI,随机分成AMI和卡维地洛微小剂量组。另设假手术对照组。给药 4周后行血流动力学测定和病理分析。结果　AMI组与假手术组相比 ,左室舒张末压 (LVEDP)、容积 (LVV)、重量 (LVW )均显著增加(P均 <0 .0 0 1) ,左室内压最大上升和下降速率 (±dp/dp)及其校正值 (±dp/dt/LVSP)均显著降低 (P <0 .0 1～0 .0 0 1)。卡维地洛组与AMI组相比 ,LVEDP、LVV和LVW均显著降低 (P均 <0 .0 1) ,±dp/dt及±dp/dt/LVSP均显著增加 (P <0 .0 5 ～ 0 .0 1)。结论　卡维地洛微小剂量即能有效防止大鼠AMI左室重构 ,改善血流动力学和左室功能     

平衡法门控心血池显像评价不同分级前壁心肌梗死患者左室收缩及舒张功能

目的我们应用平衡法门控心血池显像技术对不同Killip分级的前壁心肌梗死患者进行左室总体和局部收缩和舒张功能参数的对比分析。方法对照组15例（G0）,前壁心肌梗死KillipⅠ级17例（G1）,前壁心肌梗死KillipⅡⅢ级12例（G2）。利用平衡法门控心血池显像技术评价3组的左室总体和局部的收缩与舒张功能。结果①左室整体收缩功能,在LVEF,ESC 2个参数中,G1比G0有显著差异（P<0.05）,G2分别比G1和G0有显著差异（P<0.05）。在PER、1/3EF、1/3ER 3个参数中,G2分别比G1和G0显著下降（P<0.05）。②左室总体舒张功能,在PFR、1/3FF、1/3FR、EDC中,G1比G0有显著差异（P<0.05）,G2分别比G1和G0有显著差异（P<0.05）。③左室局部收缩功能,在以LVREF为参数时,G1在4个节段比G0显著差异（P<0.05）,G2在所有6个节段中比G1和G0均显著下降（P<0.05）。④左室局部舒张功能,在以LVR1/3FF为参数时,G1在4个节段比G0显著下降（P<0.05）,G2在所有6个节段比G0和G1均显著下降（P<0.05）。结论前壁心肌梗死后出现心功能受损或心力衰竭的主要原因为左室重构。     

Preinfarction angina prevents left ventricular remodeling in patients treated with thrombolysis for myocardial infarction

BACKGROUND: It has been shown that preinfarction angina may have beneficial effects on infarct size and mortality. However, there are no studies that have serially assessed the impact of preinfarction angina on left ventricular (LV) function in a large series of patients. HYPOTHESIS: The study was undertaken to determine whether preinfarction angina (within 7 days before infarction) influences LV remodeling. METHODS: In all, 119 consecutive patients with acute myocardial infarction were serially evaluated by 2-dimensional echocardiography (on Days 1, 2, 3, and 7; at 3 and 6 weeks; and at 3, 6, and 12 months following infarction). Left ventricular volumes were determined using Simpson's biplane formula and normalized for body surface area. Wall motion score index and sphericity index were calculated for each study. Coronary angiography was performed before discharge. RESULTS: Preinfarction angina was detected in 39 of 119 patients. Initial echocardiographic and clinical data as well as the incidence of patent infarct-related artery and collaterals were similar for patients with and without preinfarction angina. In the subset of thrombolysed patients, patients with preinfarction angina showed decrease of LV end-diastolic and end-systolic volumes during the follow-up period (p = 0.033 and p = 0.001, respectively), and improvement of wall motion score index (p < 0.001) and ejection fraction occurred (p = 0.001), without changing of LV shape (p > 0.05); in addition, patients with preinfarction angina had smaller LV volumes and higher ejection fraction than did those without angina, from 3 weeks onward. These favorable effects were not detected in patients not treated with thrombolysis. CONCLUSIONS: These data indicate that preinfarction angina has an inhibiting effect on long-term LV remodeling in patients who underwent thrombolysis for first acute myocardial infarction. It appears that preinfarction angina has no impact on infarct size and early postinfarction LV function.     

卡托普利联合美托洛尔对急性心肌梗死晚期左心室重构的影响

目的探讨急性心肌梗死(AMI)后应用卡托普利联合美托洛尔治疗与单用卡托普利治疗对晚期左心室重构的影响。方法将121例AMI患者随机分成治疗组(卡托普利联合美托洛尔)63例和对照组(卡托普利)58例,采用彩色多普勒心动超声仪分别于发病后早期(<24 h)、3、6个月末连续随访并测量、计算左心室形态、构型等多项指标。结果进行治疗组早期到6个月末前后比较,左心室形态均呈逐渐扩大,6个月末最大,对照组扩大程度更明显。对照组与治疗组同期对应比较,左心室形态逐渐扩大,6个月末最明显,且差异有显著性意义。同时左心室射血分数同组和两组间对应比较,均有明显改善(P<0.05,P<0.01)。结论AMI后应用卡托普利联合美托洛尔对晚期左心室重构的抑制作用明显优于单用卡托普利。     

Left atrial remodeling in acute anterior myocardial infarction

BACKGROUND: Our goal in this study was to examine the changes in the left atrial functions over a period of 3 months by using left atrial volume measurements in patients with anterior myocardial infarction (MI). METHODS AND RESULTS: Seventy-three patients with anterior MI who consulted our hospital in the first 12 hours starting from the onset of the chest pain and who exhibited ST elevation were enrolled in the study. The left atrial functions of the patients were evaluated by transthoracic echocardiography for a total number of four times; first at the time of the visit to the hospital, then in the first week, and then in the first and third months. Eight (10.95%) of the 73 patients included in the study died during the follow-up. The remaining 65 patients completed the 3-month study period. Of these 65 patients, primary percutaneous transluminal coronary angioplasty (PTCA) was performed for 24 (36.9%) patients and thrombolytic therapy was given to 13 (20%), whereas 28 (43.1%) patients were given only medical treatment. Left atrium (LA) maximum transverse diameter, LA maximum, minimum, and presystolic volume, LA active emptying volume and fraction were found to increase significantly in comparison to baseline detected for this parameter in the first and third months (P < 0.001). However, LA passive emptying volume and fraction was found to decrease significantly in comparison to baseline detected for this parameter in the first and third months (P < 0.001). CONCLUSIONS: An increase in the diameter, volume, and dimensions of LA during atrial remodeling was detected. LA passive emptying fraction was found to decrease, whereas atrial active emptying function was found to increase to compensate for this change.     

QRS记分与陈旧性心肌梗死左室功能的关系

为评价常规心电图ＱＲＳ记分与陈旧性心肌梗死者左室功能的关系，我们对５２例陈旧性心肌梗死者的ＱＲＳ记分与平衡法核素血池测得的ＬＶＥＦ，ＰＥＲ，ＰＥＲ，１／３ＥＦ，１／３ＦＲ，１／３ＥＲ，１／３ＥＦ进行相关分析，发现ＱＲＳ记分不仅与反映收缩功能的ＬＶＥＦ，ＰＥＲ，１／３ＥＦ，１／３ＥＲ明显负相关，而且与反映舒张功能的ＰＥＲ，１／３ＦＲ，１／３ＥＦ明显负相关，结果提示ＱＲＳ记分可用于估测陈旧性心肌梗死的