心肌梗塞室壁节段运动异常的二维超声心动图定量观察

二维超声心动图(2DE)心尖两切面对室壁节段运动的定量测定,选用固定轴系统优于浮动轴系统。本文旨在应用2DE心尖两切面固定轴10节段面积法对心肌梗塞(MI)患者室壁节段运动异常(RWMA)的程度、范围和定位进行定量评价。

QUANTITATIVE ASSESSMENT OF REGIONAL WALL MOTION ABNORMALITIES WITH TWO-DIMENSlTNAL ECHOCARDIOGRAPHY IN PATIENTS WITH MYOCARDIAL INFARCTION

Quantitative assessment of the severity, extent and location of regional wall motion abnormalities (RWMA)was made with apical biplane two-dimen-sional echocardiography (2DE) using fixed-axis reference system, ten-segment division area method in 56 patients with old myocardial infarction(OMI). They were divided into 3 groups: inferoposterior wall MI (IWMI) group, 15 cases, anterior wall MI (AWMI) group, 28 cases; and extensive anterior wall MI with ventricular aneurysm (EAWMI with VA) group, 18 cases. The results showed: (1) RWMA was significantly severer in AWMI group than in IWMI group and the most severe in EAWMI with VA group, (2) The extent of RWMA was the smallest in IWMI group, significantly larger in AWMI group and the largest in EAWMI with VA group, the percentages of severe RWMA segment to total segment were 14.0%, 33.5% and 55.0%, respectively (IWMI vs. AWMI, p<0.01, AWMI vs. EAWMI with VA p<0.001), (3)RWMA segments were located at the inferior base and medium, and septal base in IWMI group, at both coronal and sagittal apices and their surrounding anterior, septal and inferior medium and lateral segments in AWMI group, and at the whole left ventricle except anterior base and lateroposterior segments in EAWMI with VA group. Both coronal and sagittal apices were much more frequently involved in both EAWMI with VA and AWMI groups then in IWMI group, the percentages of cases involving both two apices were 100%, 87% and 0%, respectively (EAWMI with VA vs. IWMI, both p<0.001). The paradoxical movement segments in EAWMI with VA group were mainly located at the coronal and sagittal apices, inferior and septal medium segments. It indicates that the quantitative analysis of RWMA in patients with MI by 2DE is accurate and feasible.