心肌梗死部位对缺血性二尖瓣反流影响的研究

目的探讨心肌梗死部位和缺血性二尖瓣反流的关系。方法应用超声心动图检测正常人前壁及下壁心肌梗死患者二尖瓣反流程度及左室、二尖瓣装置重构情况。结果下壁心肌梗死患者反流发生率高,程度重;左室和二尖瓣装置重构方面,下壁心肌梗死患者收缩功能更低,收缩末期容积指数更大;二尖瓣瓣叶闭合面积、瓣环面积、后乳头肌与二尖瓣前瓣环的距离的增加更为明显。多元逐步回归分析结果表明前壁和下壁心肌梗死患者的反流主要决定因素也不同。结论下壁心肌梗死较前壁心肌梗死反流更严重,其原因主要在于左室、二尖瓣装置重构的不同。

Influence of myocardial infarction location on ischemic mitral regurgitation

Objective To investigate the influence of myocardial infarction (MI) location on ischemic mitral regurgitation. Methods The degree of mitral regurgitation, left ventricle and mitral apparatus remodeling of normal control subjects, prior anterior MI and inferior MI patients were detected by echocardiography. Results The degree and incidence of MR were higher in patients with inferior MI than that of anterior MI patients. Lower ejection fraction and higher systolic volume index were found in patients with inferior MI patients than that of anterior MI. The increase in mitral leaflet closure (MLC), mitral annular area (MAA), the length between the posterior papillary muscle tips and the contralateral anterior mitral annular (PPM-AMA) were significantly higher in patients with inferior MI. Multivariate analysis based on stepwise multiple linear regression showed that the major determinants of MR in patients with anterior MI, and inferior MI were different. Conclusion IMR were more severe in inferior MI due to the different influence on left ventricle and mitral apparatus remodeling.