期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 276, 期 -, 页码 1-7出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2018.09.114
关键词
Myocardial infarction; Myocardial perfusion contrast echocardiography; Heart failure; Cardiogenic shock; Tako-tsubo syndrome; Stress-induced cardiomyopathy
资金
- GE Investigor Initiated Trial
- National Natural Science Foundation of China [8170020989]
Background: In patients with acute anterior myocardial infarction (MI), sometimes an apical ballooning contractile dysfunction pattern that exceeds factual myocardial injury is identified in the ventriculography and bedside echocardiography. The hemodynamic consequences/sequela of this Tako-tsobu effect has not been well delineated. Of note, this anatomic imaging finding often misleads frontline physicians who assume reciprocal causation of persistent cardiac pump failure and ventricular pressure overload. Methods and results: Using real-time myocardial perfusion contrast echocardiography (MCE), we investigated myocardial (microvascular) perfusion in 60 patients after acute MI and coronary revascularization. Twenty-eight percent of the studied patients showed significantly mismatched myocardial perfusion and contractile defects. In these patients, an integrated imaging assessment with coronary angiography/ventriculography, deformation echocardiography, and MCE proved that the myocardial mechanic abnormalities significantly exceeded the defected perfusion areas. Compared with 72% of the patients without perfusion-contractility mismatch, apparently worse systolic functions (left ventricular ejection, wall motion score, and systolic longitudinal strain) in these patients did not change diastolic ventricular filling pressures (E/E' and E/A) or hemodynamic consequences/adverse events. Both systolic and diastolic functions in patients with perfusion-contractility mismatch appeared to be comparable with those in patients with Tako-tsubo syndrome. Conclusions: Real-timeMCE identifies discrepant myocardial microvascular perfusion and mechanics in patients with acute MI. The Tako-tsubo effect in patients with perfusion-contractility mismatch does not cause diastolic filling pressure change or worse hemodynamic consequence/cardiac event. (c) 2018 Published by Elsevier B.V.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据