老年缺血性心肌病的超声心动图分析

目的超声心动图分析老年缺血性心肌病（ＩＳＣＭ）患者心脏形态结构、左室收缩及舒张功能特点以及瓣膜返流情况。方法应用２．２５ＭＨｚ探头观察了４０例ＩＳＣＭ患者和３４例老年陈旧性心肌梗死（ＯＭＩ）患者心脏的形态结构数据，左室收缩功能及舒张功能的多项指标，心脏瓣膜的返流情况特别是二尖瓣返流。结果（１）前壁ＯＭＩ患者易导致此病的发生；（２）ＩＳＣＭ组左室及左房较正常对照组和ＯＭＩ组均明显增大；（３）左室射血分数（ＬＶＥＦ）在ＩＳＣＭ组中明显减低，ＯＭＩ组主要表现为左室舒缓功能减退，而ＩＳＣＭ组则主要表现为左室顺应性降低；（４）ＩＳＣＭ组的二尖瓣返流程度明显重于ＯＭＩ组，其他瓣膜的返流情况也是ＩＳＣＭ组严重。结论ＩＳＣＭ多见于前壁心肌梗死患者，主要表现为心脏扩大，左室收缩功能减退及左室顺应性降低，在瓣膜返流中以二尖瓣返流多见且严重。

A Study in aged patients with ischemic cardiomyopathy by echocardiography

Objective The purpose of the study was to evaluate the chamber size,the left ventricular systolic and diastolic function and the valvular regurgitation in aged patients with ischemic cardiomyopathy(ISCM)by echocardiography. Methods The chamber size,the left ventricular systolic and diastolic function and the valvular regurgitation were determined in 40 aged patients with ischemic cardiomyopathy and 34 aged patients with old myocardial infarction(OMI)by 2 dimensional and Doppler echocardiography. Results (1)In ISCM patients there were 23 cases (58%)with old myocardial infarction and among these 23 patients,20 had anterior wall myocardial infarction.It was shown that patients with anterior wall infarction were liable to develop ischemic cardiomyopathy.(2)Patients with ISCM had significantly larger left ventricular and left atrial diameter than patients with OMI.(3)Patients with ISCM had significantly lower left ventricular ejection fraction than patients with OMI.Patients with OMI had decreased left ventricular relaxation function,while patients with ISCM had decreased left ventricular compliance.(4)Mitral and other valvular regurgitation were significantly more severe in group ISCM than group OMI. Conclusions These results suggest that anterior wall myocardial infarction was more frequently seen in ISCM than posterior wall infarction.Patients with ischemic cardiomyopathy were associated with left ventricular enlargement and decreased myocardial contractility and compliance.Mitral regurgitation was much more common and severe in ISCM.