摘要
目的分析陈旧性心肌梗死合并室壁运动异常患者最初5年超声心动图变化和主要心脏不良事件(MACE)发生情况。方法收集2011年1月~2016年12月两次及多次住院治疗的66例陈旧性心肌梗死合并室壁运动异常患者最初5年的超声心动图及相关临床资料,分别分析连续3个时间段(A段病史≤1年、1年<B段病史≤3年、3年<C段病史≤5年)患者超声心动图参数变化特征和MACE,评估心肌梗死后心功能改变、心室重构、MACE发生率,以及后二者之间的相互关联。结果 A、B、C时间段内患者左心房内径(LAd)、左心室舒张末期内径(LVDd)、左室射血分数(LVEF)、MACE发生率均有明显差异(P均<0.05),LAd、LVDd逐渐增大,LVEF逐渐降低、MACE发生率逐步升高;并且3个时间段内LVDd与MACE均呈正相关(P均<0.05)。结论陈旧性心肌梗死合并有室壁运动异常的患者在发病5年内发生不同程度的左心室重构,伴有左心室功能逐渐降低和主要心脏不良事件发生率逐步升高,并且左心室重构与患者预后相关。
Objective To retrospective explore ventricular remodeling （VR） and heart function by a ultrasonic car- diogram （UCG） testing, and the correlation between VR and major adverse cardiac events （MACEs） to patients with old myocardial infarction （OMI） and abnormal wall motion in first 5 years. Methods We made an observational retrospective fellow-up study involving a group of 66 patients hospitalized more than 2 times from January 2013 to December 2016. The general clinical data and characteristics of UCG collected to evaluate the heart function, VR and MACEs, as well as asso- ciation between VR and MACEs. We divided the first 5 years history of OMI into 3 consecutive time segments, named A （≤lyear）, B （〉lyear, ≤3years） and C（〉3years, ≤5years）, respectively. Results The left atrial dimension （LAd）, left ventricular end-diastolic dimension（LVDd）, left ventricular ejection fraction（LVEF）, and the combined incidence of MACEs of patients were all significantly different among A, B and C segments （P〈0.05）. LAd, LVDd and MACEs were gradually increased, while LVEF was decreased from A to C segments. The LVDd and MACEs had a positive cor- relation in A, B and C segments （r=0. 233, P=0. 032s r=0. 351, P=0. 022s r=0. 421, P=0. 016 respectively）. Conclusions The left ventricular remodeling had occurred at different extents, and correlated with prognosis in most patients with OMI and abnormal wall motion in first 5 years, with left ventrieular function be decreased, and MACEs risk be increased.
出处
《西部医学》
2017年第12期1680-1682,1687,共4页
Medical Journal of West China
基金
青海省科技计划项目(2014-ZJ-749)
关键词
陈旧性心肌梗死
室壁运动异常
超声心动图
左室重构
主要心脏不良事件
Old myocardial infarction
Ultrasonic cardiograms Abnormal wall motions Ventricular remodeling
Major adverse cardiac events
