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目的探讨研究心脏电机械标测系统(NOGA)对急性心肌梗死(AMI)患者存活心肌的标测。方法11例AMI患者持续性胸痛发作12 h内急诊入院,急诊行经皮冠状动脉介入治疗(PCI)后第7天分别进行NOGA标测、心脏超声及核素心肌显像测定。结果NOGA系统测定出梗死区域的单极电压(UVP)显著低于非梗死区域[(6.8±3.1)与(10.9±3.1)mV,P<0.01],同时梗死区域内膜下心肌短缩率(LLS)明显小于非梗死区域心肌[(4.3±3.5)与(10.4±5.5)%,P<0.01]。特征性曲线分析NOGA判断心肌存活状态的UVP界定值为8.0 mV(敏感性及特异性均为73%)。结论LLS与心肌核素扫描及心脏超声相关性良好,当UVP≥8.0 mV时提示心肌处于存活状态。
Objective To investigate the measurement of viable myocardium in patients with acute myocardial infarction (AMI) by electrocardiographic mechanical mapping system (NOGA). Methods Eleven patients with acute chest pain were admitted to hospital within 12 hours after onset of persistent chest pain. NOGA mapping, echocardiography and myocardial imaging were performed on the 7th day after percutaneous coronary intervention (PCI). Results NOGA system showed that the unipolar voltage (UVP) in the infarcted area was significantly lower than that in the non-infarcted area [(6.8 ± 3.1) vs (10.9 ± 3.1) mV, P <0.01] LLS) was significantly lower than that in non-infarcted myocardium [(4.3 ± 3.5) vs. (10.4 ± 5.5)%, P <0.01]. Characteristic Curve Analysis The NOGA was used to determine the survival of the myocardium with a UVP cutoff of 8.0 mV (73% sensitivity and specificity). Conclusions LLS has good correlation with myocardial radionuclide scanning and echocardiography. When UVP≥8.0 mV, it indicates that myocardium is in a viable state.