Clinical Application of CADL in the Patients with Acute Myocardial Infarction
Xiaoxian Qian, Sun Yat-sen · Journal of Sun Yat-sen University · 2003
[Objective] To investigate the clinical value of cardiac admittance differential loop (CADL) in reflecting the changes of coronary flow and cardiac function and predicting the outcome of the patients with acute myocardial infarction (AMI). [Methods] 33 patients with definite diagnosis of AMI were selected, in which 21 patients with intravenous thrombolysis and 12 patients without thrombolysis . CADL were tested for four weeks and compared with clinical symptom, ECG and CK-MB. 40 healthy adults were selected as the control group. [Results] CADL of eighteen patients in intravenous thrombolysis group ameliorated gradually which were consistent with short - term clinical outcome: the notch in phase I lessened, even disappeared, the ratio of pre - ejection period to left ventricular ejection time( TPEP/LVET) decreased from 0. 46 ± 0. 15 to 0. 32 ±0. 12, the ratio of area of phase Ⅰ + Ⅱ to total area[ ( Ⅰ + Ⅱ)% Jincreased from 60. 24% ± 12. 15% to 87. 37% ± 13. 28%, the ratio of area of phase Ⅲ to area of Ⅰ + Ⅱ ( rⅢ/Ⅰ+Ⅱ) decreased from 0. 23 ± 0. 18 to 0. 08 ± 0. 03, the ratio of area of phase V to area of Ⅰ+Ⅱ(rⅤ/Ⅰ+Ⅱ) decreased from 0. 37 ± 0. 34 to 0. 10 ±0. 05. Three patients died of cardiogenic death whose CADL deteriorated. In the non - thrombolysis group, the changes of CADL were consistent with short - term outcome. The positivity of notch in phase I (84. 8% ) were higher than ECG(81. 8% ) but there was no difference between them. [ Conclusion] The changes of CADL could reflect indirectly the changes of myocardial blood supply and cardiac function of the patients with AMI. Dynamic observation of CADL had practical value to evaluate the treatment and the short - term prognosis of the patients with AMI.