| Since different reperfusion methods (i.e., thrombolysis, direct PICA and /or stent) will differently influence the patency rate of the infraction related vessel, infarction size, heart function and prognosis et al, selecting the most suitable therapy is crucial early after acute myocardial infarction. To evaluate the clinical value of Pulsed-wave Doppler Tissue Imaging (PWDTI) in estimating the effect of each therapy and find a proper parameter, we measured the velocities of mitral annulus and infarction segments with PWDTI quantitatively one week after infarction, together with the data of traditional echocardiography. Moreover, all patients received 1 month and 3 months' follow-up after infarction, respectively. Results:1. 72 patients were divided into PCI group (30 cases), thrombolysis group (27cases) and conservative group (\5 cases). The general echocardiography parameters of left ventricular function at 1 week, 1 month and 3 month after acute myocardial infarction showed that the left ventricular ejection fraction (LVEF) and Fractional area change (FAC) of PCI group and thrombolysis group were both higher than those of conservative group's, but left ventricular end-diastolic dimension (LVDD) and left ventricular end-systolic dimension (LVSD) of two groups were lower than those of conservative group's. However, there is no significance difference between the two groups. 1 month and 3 months after infarction, both PCI group and thrombolysis group demonstrated decreased LVEF and FAC as well as enlarged LVDD and LVSD compared with those of 1 week's. In spite of alteration in conservative group, there is no statistical significance. The patients will benefit from timely reperfusion.2. PWDTI parameters of mitral annulus: 1 week, 1 month and 3 months after infarction, duration of S wave (Ds), duration of e wave (De), peak systolic velocity (Vs), Peak early diastolic velocity (Ve), e/a, systolic velocity-time integral (VTIs), early diastolic velocity-time integral (VTIe), acceleration of S wave (ACCs) of PCI group and thrombolysis group showed amelioration when compared with those of conservative group's. Although PCI group has higher Vs at 1 month, there is no significance difference between PCI group and thrombolysis group 3 months after infarction. Self-comparison of each groups: Vs, Ve, Va, the ratio e to a (e/a), VTIs, VTIe, ACCs of PCI group and thrombolysis group were improved after therapy. It is noteworthy that the improvements of Vs^ VT^ ACCs were distinct. However, only VTIs and ACCs of conservative group, which represent systolic function, were improved.(1) Additionally, 3 groups were divided into anterior infarction and inferior infarction sub-groups further. In the anterior infarction sub-groups we found theVs, Ve, VTIs and VTIe of PCI group and thrombolysis group at 1 week, 1 month and 3 months were higher than those of conservative group's, but there is no significance between the two groups. In the inferior infarction sub-groups, the Vs and VTIs of PCI group and thrombolysis group were higher than those of conservative group's too. Though the Vs, VTIe and VTIs of PCI group at 1 month were higher than those of thrombolysis group, only VTIs of PCI group was higher than thrombolysis group at 3 month. Self-comparison of each anterior and inferior infarction sub-groups: The Vs, Ve, VTIs and ACCs of PCI group were higher at 1 month and 3 months than those of 1 week's. However, only Vs increased when the parameters of 1 month's compared with 3 month's. The data of conservative group had no significant alteration during the 3 months. In thrombolysis group, the Vs, Va, VTIs, VTIe and ACCs of inferior infarction sub-group were higher than those of anterior infarction sub-group's at 1 month and only the VTIs and late diastolic velocity-time integral (VTIa) of inferior infarction sub-group were higher than those of anterior infarction sub-group's at 3 months. There was no significant change between the anterior infarction and inferior infarction sub-groups of conservative group.(2) The thrombol... |
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