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目的通过长期随访观察冠心病患者再灌注前后多巴酚丁胺负荷超声心动图的改变,探讨在不同负荷条件下再灌注存活心肌的变化。方法行经皮冠状动脉成形术加支架术的冠心病患者52例,于术前、术后6个月及3年应用多巴酚丁胺负荷超声心动图观察其不同负荷条件下左室射血分数(LVEF)和室壁运动的变化。结果术后6个月静息状态LVEF提高≥5%患者分为A组,其余归为B组。A组和B组患者的基本情况无明显差别。A组患者术后6个月及术后3年静息及不同负荷条件下LVEF持续增加,左室室壁运动记分指数(WMSI)持续减低。B组患者静息LVEF提高不明显,但术后6个月、3年在负荷条件下LVEF持续升高,WMSI持续减低。结论负荷条件下LVEF和WMSI的改变对评价患者存活心肌再灌注具有重要价值。
Objective To observe the changes of dobutamine stress echocardiography before and after reperfusion in patients with coronary heart disease through long-term follow-up and to investigate the changes of myocardial viability after reperfusion under different loading conditions. Methods Fifty-two patients with coronary heart disease underwent percutaneous transluminal coronary angioplasty (PTCA) plus stenting were included in this study. Left ventricular ejection fraction (LVEF) under different loading conditions was observed before and 6 months and 3 years after dobutamine stress echocardiography (LVEF) and wall motion changes. Results At 6 months after operation, the LVEF increased more than 5% at the resting state. The patients were divided into A group and the rest were divided into B group. The basic situation of patients in group A and group B had no significant difference. The LVEF increased continuously and the left ventricular wall motion score index (WMSI) decreased continuously at 6 and 6 months after operation in group A and resting at different load for 3 years. The resting LVEF was not obvious in group B, but the LVEF increased continuously and the WMSI decreased continuously at 6 months and 3 years after operation. Conclusion The changes of LVEF and WMSI under load are of great value in evaluating the survival myocardial reperfusion in patients.