小剂量多巴酚丁胺负荷超声心动图试验对可逆性功能障碍心肌预测的新指标

目的：探讨小剂量多巴酚丁胺负荷超声心动图（DSE）试验中左心室功能EF值的变化，即ΔEF这一量化指标预测急性心肌梗死（AMI）后患者的功能障碍心肌是否可逆及其可恢复程度。方法：入选患者25例, 接受小剂量DSE检查，测定负荷试验各阶段的收缩功能EF值，25例患者亦接受冠脉造影，并择期行经皮经腔太动脉成形术（PTCA）治疗，根据病变血管的情况植入支架，在术后3．5－13个月之间复查小剂量DSE试验。结果：以小剂量DSE过程中EF增加值，即ΔEF大于等于15％作为衡量标准，预测可逆性功能障碍心肌的敏感性，特性和准确性分别为70．6％，75％和72％，此预测改善值与无改善值之间的差异有显著性意义（P＜0．05），结论：ΔEF可以作为准确评价可逆性功能障碍心肌的指标，并且是一种定量测定方法。

Prediction of reversible myocardial dysfunction using low-dose dobutamine stress echocardiogrophy

Objective　The accurate recognition of reversible myocardial dysfunction may allow a more rational recommendation for coronary revascularization. The low-dose dobutamine stress echocardiography have been proposed for the defection of myocardial viability.The alteration of EF(ΔEF) during low-dose DSE was used to be a target to judge the reversible myocardial dysfunction.Methods　In the patients with definite acute myocardial infarction, low-dose DSE was performed before and after elective coronary angioplasty. The left ventricular systolic function was evaluated according to the Simpson′s rule before and during dobutamine infusion ( 5 and 10 μg*kg-1*min-1). Results　The sensitivity, specificity and accuracy for determining the predictive values of pre-angioplasty DSE on regional recovery reached 70.6%,75% and 72%,respectively.Conclusions　The alteration of EF (ΔEF) can be considered to be a standard to judge whether the myocardial dysfunction is reversible or not.