藤田 俊弘¹, 椎名 明¹, 鈴木 修², 黒田 敏男¹, 山沢 正則¹, 夏目 隆史¹, 柳沼 淑夫¹

Toshihiro FUJITA¹, Akira SHIINA¹, Osamu SUZUKI², Toshio KURODA¹, Masanori YAMASAWA¹, Takashi NATSUME¹, Toshio YAGINUMA¹

¹自治医科大学循環器内科, ²自治医科大学臨床病理

¹Department of Cardiology, Jichi Medical School, ²Department of Clinical Pathology, Jichi Medical School

キーワード : Prognosis, Wall motion, Myocardial infarction, Two-dimensional echocardiography

To evaluate the long-term prognosis for LV wall motion changes subsequent to acute myocardial infarction (MI), we studied 52 patients using 2-dimensional echocardiography from the onset to 1-4 years after MI. Regional wall motion was improved in 21 of 28 patients (75%) without dyskinesis during the follow-up period and in 16 of these 21 patients (76%) within a week after the onset of ML In contrast, it was improved in only 8 of 24 patients (33%) with dyskinesis within a week after the onset. Of 25 patients who showed akinesis or severe hypokinesis seven days after the onset of MI, it was improved further in 12 patients (48%) and worsened in only 2 (8%). In contrast, of 13 patients who showed dyskinesis at the 7th day, only 4 patients (31%) improved and 7 (54%) worsened. Of 35 patients who showed better wall motion than akinesis at the 7th day, only 2 patients (6%) died, compared to 5 deaths among 16 patients (31%) who showed dyskinesis or aneurysms. Tendency to wall motion improvement was almost similar in both anterior and inferior MI except for patients who died in early stage of the disease. The number of significant coronary lesions, development of collateral vessels, age or sex did not affect the long-term prognosis for wall motion. In 18 of 22 patients (82%) without wall thinning as found by 2-dimensional echocardiography, there was significant improvement. In conclusion, both the short-term and long-term prognosis for wall motion and mortality was reflected by serial changes and severity in regional LV wall motion within a week after the onset of MI, and dyskinesis was a strong predictor for a poor prognosis.