渐进的左心室功能障碍和心肌梗塞后的重塑. 潜在的机制和早期预测因素
P Gaudron1, C Eilles, I Kugler
1Department of Medicine, Julius-Maximilians-University, Würzburg, FRG.
Circulation
|March 1, 1993
概括
心肌梗塞后的左心室扩张可以补偿或导致慢性心力衰竭. 使用特定预测因子早期识别逐渐扩张,可以帮助管理高风险患者.
科学领域:
- 心脏病学 心脏病学
- 心血管研究研究心血管研究
- 肌肉心脏病发作 肌肉心脏病发作
背景情况:
- 心肌梗塞后的左心室扩大预测了生存率.
- 慢性心力衰竭的发展是一个重大问题.
- 缺乏关于心室扩大和心脏功能障碍的前性研究.
研究的目的:
- 定义左心室扩张和心脏功能障碍之间的关系.
- 确定心肌梗塞后心室扩大和心力衰竭的早期预测因素.
主要方法:
- 对70名心肌梗塞后患者的前性评估.
- 评估左心室体积,区域功能 (带门的SPECT),射出分数和血液动力学.
- 随访时间为4天,4周,6个月1.5年,3年.
主要成果:
- 患者分为逐渐扩张,有限扩张或没有扩张.
- 有限扩张 (26%) 是补偿性的;渐进扩张 (20%) 导致功能障碍.
- 确定了早期预测因素:射出分数,中风指数,心脏病发作大小,位置和动脉 perfusion 等级.
结论:
- 有限的左心室扩张可以作为心脏病发作后的补偿.
- 逐渐扩张导致严重的全球左心室功能障碍.
- 高风险患者的早期鉴定在心脏病发作后4周内是可能的.
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