[雙語翻譯]醫(yī)學外文翻譯--在急性前壁心肌梗死中遠端保護對左室功能的影響（英文）

1、ORIGINAL PAPEREffects of distal protection on left ventricular function in acute anterior myocardial infarction: a Doppler echocardiographic studyYun-Yan Duan Æ Hai-Bin Zhang Æ Li-Wen Liu Æ Xiao-Dong Zhou

2、Æ Cheng-Xiang Li Æ Jun Li Æ Ting Zhu Æ Hai-Li Su Æ Yong-Sheng Zhu Æ Hong-Ling Li Æ Jun ZhangReceived: 14 January 2009 / Accepted: 16 September 2009 / Published online: 4 October 2009 ?

3、Springer Science+Business Media, B.V. 2009Abstract Whether distal protection devices (DPDs) during percutaneous coronary intervention (PCI) can improve myocardial function in patients with acute myocardial infarction (AM

4、I) is still under debate. Using tissue Doppler imaging (TDI), we evaluate the global and regional left ventricular systolic and diastolic functions in patients with anterior AMI using DPDs compared with conventional PCI.

5、 Ninety-six patients with anterior AMI were randomly assigned to either PCI with DPDs (DPD, n = 46) or traditional PCI (control, n = 50) groups. At the 3- and 6-month follow-ups, the DPD group had a higher left ventricul

6、ar ejection fraction than the control group (51.6 ± 3.6 vs. 49.3 ± 5.3% and 53.0 ± 3.7 vs. 50.8 ± 5.2%, respectively; both P \ 0.05).Moreover, peak systolic (Sa) and early diastolic (Ea) mitral annula

7、r velocities obtained by TDI were significantly higher in the DPD group than in the control group (Sa: 7.57 ± 0.53 vs. 7.12 ± 0.62 cm/s and 7.71 ± 0.63 vs. 7.32 ± 0.59 cm/s; Ea: 7.23 ± 0.78 vs. 6

8、.89 ± 0.86 cm/s and 7.49 ± 0.69 vs. 7.04 ± 0.85 cm/s, respectively; all P \ 0.05). However, systolic and diastolic regional myocardial velocities significantly improved in the DPD group from the 1-month fo

9、llow-up compared with those in the control group (all P \ 0.05). Patients who received treatment with DPDs experienced enhanced improvement of cardiac function. Thus, anterior AMI patients can benefit from DPDs during PC

10、I.Keywords Echocardiography ? Tissue Doppler imaging ? Distal protection devicesAbbreviations A Peak flow velocity during late diastole AMI Acute myocardial infarction DPDs Distal protection devices E Peak flow velocity

11、during early diastole Ea Peak early diastolic mitral annular velocities Em Peak early diastolic myocardial velocities LAD Left anterior descending coronary artery LV Left ventricle/ventricular PCI Percutaneous coronary i

12、ntervention RWMSI Regional wall motion score index Sa Peak systolic mitral annular velocitiesYun-Yan Duan and Hai-Bin Zhang contributed equally to this study.Y.-Y. Duan ? H.-B. Zhang ? L.-W. Liu ? X.-D. Zhou ? J. Li ? T.

13、 Zhu ? H.-L. Su ? Y.-S. Zhu ? H.-L. Li ? J. Zhang ( flow grade 3 within the vessel was considered to be normal. The post-intervention and follow-up therapy strategies were similar in the two groups.Echocardiographic exam

14、inationEchocardiography was performed before PCI and at 1, 3, and 6 months after PCI. The observer was blind to all clinical and angiographic data. All echocardio- grams were performed with an ultrasound system (HDI 5000

15、 ATL, Philips Medical System, USA). The LV volumes and ejection fractions were calculated using the modified biplane Simpson’s formula with images obtained from the apical four- and two- chamber views as recommended by t

16、he American Society of Echocardiography [16]. Pulsed Doppler measurements of LV filling were obtained in the apical four-chamber view, with the sample volume placed at the level of the mitral tips. We obtained peak flow

17、velocities during early (E) and late (A) diastolic filling, and the diastolic transmitral E/A velocity ratio. The pulsed wave TDI was acquired from apical four-chamber, two-chamber, and long-axis views. A 5-mm sample vol

18、ume of TDI was positioned in six points of the mitral annulus, and the peak systolic (Sa) and peak early diastolic (Ea) velocities weremeasured to assess global LV systolic and diastolic functions. The results are report

19、ed as a mean of the six samples of the mitral annulus. Measurements of the regional myocardial veloci- ties were sampled in basal, mid-level, and apical segments of the LV anterior walls from apical two- chamber views. P

20、eak systolic myocardial velocities (Sm) and early diastolic myocardial velocities (Em) were obtained. The LV anterior wall motion was semiquantitatively graded from 1 to 4 as follows: 1 = normal, 2 = hypokinesis, 3 = aki

21、nesis, and 4 = dyskinesis. The regional wall motion score index (RWMSI) of the anterior wall was derived from the mean of the three segment scores [16]. We previously reported the methods and repro- ducibility of TDI ind

22、ices in our laboratory [17, 18]. Intra-observer variability was 4.2 ± 2.2% for Sa, 4.4 ± 2.2% for Ea, 3.8 ± 1.8% for Sm, and 4.0 ± 2.3% for Em. The corresponding values for inter- observer variability

23、 were 4.9 ± 2.7%, 5.5 ± 2.9%, 4.6 ± 2.5%, and 5.2 ± 2.4%, respectively.Statistical analysisValues are expressed as the means ± standard devi- ations, when appropriate. Group differences were dete

24、cted by the Student’s t-test or analysis of variance (ANOVA) for continuous variables and v2 test for discrete variables. A P value \ 0.05 was considered statistically significant. All statistical analyses were performed

25、 using standard statistics software (SPSS Version 10.0).ResultsGeneral clinical characteristicsDuring the enrollment period, 178 patients with their first, anterior AMI were screened. Of these patients, 96 were eligible

26、for randomization. Fifty patients were randomly assigned to the control group and 46 to the DPD group (Fig. 1). The ages of these patients (81 males) were between 31 and 75 years with a mean age of 56 ± 7 years. Bas