单纯急性下壁心肌梗死及其合并右心室心肌梗死对右心长轴功能的影响

目的应用心肌组织多普勒技术结合M型超声心动图,评价单纯急性下壁心肌梗死及其合并右心室心肌梗死对右心室长轴功能的影响。方法选择首次急性下壁心肌梗死患者28例,分为单纯急性下壁心肌梗死18例(Ⅰ组),急性下壁心肌梗死伴右心室心肌梗死10例(Ⅱ组),另选健康体检者20例(Ⅲ组)。在标准心尖四腔心切面二维图像指引下,应用M型超声记录右心房室环右心室游离壁及中心纤维支架处运动曲线,测量收缩期、舒张早期、舒张晚期最大运动幅度(SD,DED,DAD)及收缩期、舒张早期、舒张晚期平均运动速度(SMV,DEMV,DAMV),计算DED/DAD比值。心肌组织多普勒记录该处运动速度曲线,测量上述各期最大运动速度(Sm、Em、Am)及Em/Am比值。结果与Ⅲ组比较,Ⅰ组和Ⅱ组右心房室环右心室游离壁处SD、DED、DED/DAD、SMV、DEMV、Sm及Em均明显下降。DAD、DAMV、Am虽有下降,但差异无统计学意义。结论急性下壁心肌梗死无论是否合并右心室心肌梗死均可影响右心室长轴功能,导致右心室整体功能降低。

Influence of acute inferior myocardial infarction with or without right ventricular infarction on right ventricular function

Objective To evaluate the influence of acute inferior myocardial infarction(MI) with or without right ventricular infarction on long-axial function of right ventricle examined with tissue Doppler imaging and M-mode echocardiography.Methods Twenty-eight patients with a first a- cute inferior MI,ineluding eighteen without and ten with RV infarction,were compared with 20 age-matched healthy individuals.The motion of the tricuspid annulus at the RV free wall in apical 4-chamber views was recorded and the amplitudes(SD,DED,DAD) and mean velocities of systole and early and late diastole(SMV,DEMV,DAMV)were measured by 2-dimensional image guided M-mode echocardiography,and the amplitnde ratio of early and late diastole(DED/DAD) was cal- culated.Peak systolic and early and late diastolic velocities (Sm,Em,Am) of the tricuspid annulus were also recorded at the same site by tissue Doppler imaging and the ratio of peak early and late diastolic velocities(Sm/Am) was calculated too.Results Compared with those in healthy individ- uals,the SD,DED,DED/DAD,SMV,DEMV,Sm and Em were reduced dramaticaly in inferior MI whether without or with RV infarction.Compared with inferior MI without RV infarction group, these parameters were lower in inferior MI with RV infarction group,but the difference had no statistical significance.Conclusion In patients with inferior MI,whether with or without RV in- farction,there is damage of RV long-axial function.