科研之友
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摘要
Background/Aim. Prognosis after acute myocardial infarction (A I M) depends on the extent of irreversibly damaged myocardium and viable tissue due to stunning or hibernation. The aim of the study was to assess the prognostic significance of early echocardiographic parameters of in myocardial viability in prediction of late recovery of regional and global ventricular function. Methods. The study prospectively included 40 patients after the First, uncomplicated universel AIM treated with percutaneous coronary intervention (PCI). Low-dose dobutamine echocardiography (LDDE) was preformed 7-10 days after AIM and follow-Lip testing echocardiography from 7 to 12 months hater. Results. The sensitivity and specificity for the prediction of post revascularisation regional, dyssynergy improvement were 61.29% and 94.59% respectively. The positive and negative predicative values were 90.48% and 74.47% respectively. The number of viable segments (p = 0.01) and extent of contractile reserve (p = 0.01) were univariate, independent predictors of improvement in ejection fraction (EF). From the multivariate stepwise regression analysis contracrile reserve was selected as most powerful predictor of lite recovery of left ventricular contractile p = 0.007). Receiving-operator characteristic curve (ROC) analysis demonstrated that three or more recovered segments were necessary for an improvement of left ventricular ejection Fraction (LVEF) >= 5% after the revascularisation, with the highest sensitivity, 100% and specificity 56% (p = 0.01). Conclusion. Low-dose dobutamine echocardiography is a powerful predictor of the regional dyssynergy recovery late after AIM treated with PTCA with implantation stent. Late full functional improvement of the left ventricle is related to the extent of contractile reserve and amount of viable tissue. At least three recovered segments are necessary for 1 significant recovery of the global left ventricular contractility.
- 出版日期2008-1
- 单位中国人民解放军军事医学科学院
