PDF(Pubmed)
Abstract：
UNASSIGNED: Although left ventricular (LV) diastolic dysfunction is more related to functional capacity after acute myocardial infarction (AMI), the determinants of LV diastolic functional change after reperfused AMI remain unknown. This study aimed to investigate the effects of microvascular obstruction (MVO) on mid-term changes in LV diastolic function after reperfused AMI.
UNASSIGNED: In a cohort of 72 AMI patients who underwent successful revascularization, echocardiography and cardiovascular magnetic resonance imaging were repeated at 9-month intervals. The late gadolinium enhancement (LGE) amount, segmental extracellular volume fraction, global LV, and left atrial (LA) phasic functions, along with mitral inflow and tissue Doppler measurements, were repeated.
UNASSIGNED: Among the included patients, 31 (43%) patients had MVO. During the 9-month interval, LV ejection fraction (EF) and LV global longitudinal strain (GLS) were significantly improved in accordance with a decrease in LGE amount (from 18.2 to 10.3 g, p < 0.001) and LV mass. The deceleration time (DT) of early mitral inflow (188.6 ms-226.3 ms, p < 0.001) and LV elastance index (Ed; 0.133 1/ml-0.127 1/ml, p = 0.049) were significantly improved, but not in conventional diastolic functional indexes. Their improvements occurred in both groups; however, the degree was less prominent in patients with MVO. The degree of decrease in LGE amount and increase in LVEF was significantly correlated with improvement in LV-Ed or LA phasic function, but not with conventional diastolic functional indexes.
UNASSIGNED: In patients with reperfused AMI, DT of early mitral inflow, phasic LA function, and LV-Ed were more sensitive diastolic functional indexes. The degree of their improvement was less prominent in patients with MVO.
UNASSIGNED: In a cohort of 72 AMI patients who underwent successful revascularization, echocardiography and cardiovascular magnetic resonance imaging were repeated at 9-month intervals. The late gadolinium enhancement (LGE) amount, segmental extracellular volume fraction, global LV, and left atrial (LA) phasic functions, along with mitral inflow and tissue Doppler measurements, were repeated.
UNASSIGNED: Among the included patients, 31 (43%) patients had MVO. During the 9-month interval, LV ejection fraction (EF) and LV global longitudinal strain (GLS) were significantly improved in accordance with a decrease in LGE amount (from 18.2 to 10.3 g, p < 0.001) and LV mass. The deceleration time (DT) of early mitral inflow (188.6 ms-226.3 ms, p < 0.001) and LV elastance index (Ed; 0.133 1/ml-0.127 1/ml, p = 0.049) were significantly improved, but not in conventional diastolic functional indexes. Their improvements occurred in both groups; however, the degree was less prominent in patients with MVO. The degree of decrease in LGE amount and increase in LVEF was significantly correlated with improvement in LV-Ed or LA phasic function, but not with conventional diastolic functional indexes.
UNASSIGNED: In patients with reperfused AMI, DT of early mitral inflow, phasic LA function, and LV-Ed were more sensitive diastolic functional indexes. The degree of their improvement was less prominent in patients with MVO.
摘要：
■尽管左心室（LV）舒张功能障碍与急性心肌梗死（AMI）后的功能容量更相关，再灌注AMI后LV舒张功能改变的决定因素尚不清楚.本研究旨在探讨微血管阻塞（MVO）对再灌注AMI后左心室舒张功能中期变化的影响。
■在72例成功血运重建的AMI患者中，每隔9个月重复超声心动图和心血管磁共振成像。晚期钆增强(LGE)量，分段细胞外体积分数，全局LV,和左心房（LA）相位功能，随着二尖瓣流入和组织多普勒测量，重复。
■在纳入的患者中，31例(43%)患者有MVO。在9个月的间隔中，左心室射血分数(EF)和左心室整体纵向应变(GLS)随着LGE量的减少(从18.2g减少到10.3g,p<0.001）和LV质量。二尖瓣早期流入的减速时间(DT)(188.6ms-226.3ms,p<0.001）和LV弹性指数（Ed；0.1331/ml-0.1271/ml，p=0.049)明显改善，而不是常规的舒张功能指标。两组都有改善；然而，MVO患者的程度不明显。LGE量减少和LVEF增加的程度与LV-Ed或LA相位功能的改善显着相关，但与常规舒张功能指标无关。
■在再灌注AMI患者中，早期二尖瓣流入的DT，相位LA功能，和LV-Ed是更敏感的舒张功能指标。在患有MVO的患者中，它们的改善程度不太明显。
■在72例成功血运重建的AMI患者中，每隔9个月重复超声心动图和心血管磁共振成像。晚期钆增强(LGE)量，分段细胞外体积分数，全局LV,和左心房（LA）相位功能，随着二尖瓣流入和组织多普勒测量，重复。
■在纳入的患者中，31例(43%)患者有MVO。在9个月的间隔中，左心室射血分数(EF)和左心室整体纵向应变(GLS)随着LGE量的减少(从18.2g减少到10.3g,p<0.001）和LV质量。二尖瓣早期流入的减速时间(DT)(188.6ms-226.3ms,p<0.001）和LV弹性指数（Ed；0.1331/ml-0.1271/ml，p=0.049)明显改善，而不是常规的舒张功能指标。两组都有改善；然而，MVO患者的程度不明显。LGE量减少和LVEF增加的程度与LV-Ed或LA相位功能的改善显着相关，但与常规舒张功能指标无关。
■在再灌注AMI患者中，早期二尖瓣流入的DT，相位LA功能，和LV-Ed是更敏感的舒张功能指标。在患有MVO的患者中，它们的改善程度不太明显。
