| Object: To observe the effects of some risk factors on left ventricular remodeling and function and the effects of revascularization and medical treatment on left ventricular function in the patients with myocardial infarction .To compare the changes of left ventricular remodeling and cardiac function between anterior and inferior myocardial infarction patients.Methods: Two hundred MI patients were studied. All of the patients had the typical clinical symptom of myocardial infarction and accepted coronary angiography.Patients with valvular heart diseaes , myocardiopathy and congential heart disease were excluded. Patients were divide into many groups by different way. 1.Grouping by the risk factors of coronary heart disease:Patients without hypertension and diabetes mellitus as group one. Patients with hypertension as group two,Patients with diabetes mellitus as group three.Patients with hypertension and diabetes mellitus as group four. 2.Grouping by the Clinical management: The patients were received revascularization as group one, received medical treatment as group two.After 3 months to one year following up ,LV shapes and LV remodeling were monitored by echocardiography. 3.Grouping by the position of myocardial infarction:The patients with anterior myocardial infarction as group one. The patients with interior myocardial infarction as group two.Results:1. All of the groups were found significantly different in left ventricular mass except diabetic mellitus group(P<0.01).The myocardial infarction patients with hypertension and diabetic mellitus was more worser than single factor patients. In diabetes mellitus group E, E/A was significantly decreased and the patients with two risk factors worser than that with unique factor . EDV,EDVI,ESV,ESVI,EF,FS was not found significantly different in all of the groups(P>0.05).2. In revascular group, LA(left-right) , LAV , LVD, LVS was significantly increase with on going time.And EDV, EDVL ESV, ESVI much better than that in medical treatment group(P<0.05). E, A, E/A has no different between revascular and medical treatment group .3. It was proved that left ventricular structure index significantly increase and EF significantly decrease with on going time in medical treatment group(P<0.05).Reversely, all of the index are not found difference in different points in revascular group .4. Compared with interior MI patients, LAV,LVD and LVS in patients with anterior myocardial infarction were significantly increased and EF,FS were significantly decrease. The left ventricular diastolic function has no different between two groups.Conclusions:1. The left ventricular mass was significantly increase in myocardial infarction patients with hypertension. The Lvmass was more severe than that with unique factors in the patients with two factors.2. The left ventricular diastolic function was much poor in myocardial infarction patients with diabetes mellitus group.The E,E/A was more severe than that with unique factors in the patients with two factors.3. Revascularization could protect left ventricular remodeling andimprove systolic function.4. Left ventricular remodeling and systolic function In medical treatment group was worser than that in revascularization group . However it was proved that revascularization could prevent the progress of LV remodeling and systolic function deterioration in MI patients.5. The left ventricular remodeling and systolic function was significant worser in anterior myocardial infarction patient than that in interior myocardial infarction patient. |
