摘要
目的探讨三维斑点追踪成像技术(3D-STI)对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后左心室重塑的预测价值。方法行PCI治疗的AMI患者178例根据术后1年内随访结果分为左心室重塑组(A组,45例)和非左心室重塑组(B组,133例)。比较两组临床资料和PCI术后即刻、术后72h、术后1周、术后1个月和术后1年左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)及左心室整体纵向应变(LVGLS)。绘制ROC曲线分析不同时间点LVGLS对AMI患者PCI术后左心室重塑的预测价值,多因素logistic回归分析AMI患者PCI术后左心室重塑的影响因素。结果两组糖尿病史、梗死部位及冠状动脉病变支数比例和血清尿酸(UA)、胱抑素C(CysC)水平比较均有统计学差异(P<0.01)。与B组比较,A组术后1个月和1年LVEF降低而LVEDV增加,术后72h、1周、1个月及1年LVGLS均升高(P<0.01)。术后72h、1周、1个月及1年LVGLS对AMI患者PCI术后左心室重塑均有一定的预测效能(P<0.01)。梗死部位为前壁、血清UA和CysC水平升高、术后1个月LVEDV和LVGLS增加是AMI患者PCI术后左心室重塑的危险因素,而术后1个月LVEF增加是保护因素(P<0.05)。结论3D-STI对AMI患者PCI术后左心室重塑具有较好的预测价值。
Objective To explore the predictive value of three-dimensional speckle tracking imaging(3D-STI)for left ventricular remodeling after percutaneous coronary intervention(PCI)in the patients with acute myocardial infarction(AMI).Methods A total of 178patients with AMI underwent PCI were divided into two groups of A(left ventricular remodeling,45cases)and B(non-left ventricular remodeling,133cases)according to one-year follow-up.The clinical data and left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV)and left ventricular global longitudinal strain(LVGLS)at immediately,72hours,one week,one month and one year after PCI were compared between the two groups.ROC curves were drawn to analyze the predictive value of LVGLS at different time points for left ventricular remodeling after PCI in AMI patients,and the influencing factors for left ventricular remodeling after PCI in AMI patients were analyzed by multivariate logistic regression.Results There were significant differences in the proportions of the patients with diabetes history,infarct site,and the number of coronary artery lesions,and serum levels of uric acid(UA)and cystatin C(CysC)between the two groups(P<0.01).Compared with group B,LVEF was decreased and LVEDV was increased at one month and one year after PCI,LVGLS was increased at 72hours,one week,one month and one year after PCI in group A(P<0.01).LVGLS at 72hours,one week,one month and one year after PCI had predictive value for left ventricular remodeling in AMI patients(P<0.01).The anterior wall,the increase of serum levels of UA and CysC,the increase of LVEDV and LVGLS at one month after PCI were the risk factors(P<0.05),and the increase of LVEF one month after PCI was aprotective factor for left ventricular remodeling in AMI patients(P<0.05).Conclusion 3D-STI has a good predictive value for left ventricular remodeling after PCI in patients with AMI.
作者
王荣荣
刘媛媛
郑美华
WANG Rongrong;LIU Yuanyuan;ZHENG Meihua(Department of Cardiology,Tianjin Beichen Hospital,Tianjin 300000,CHINA)
出处
《江苏医药》
CAS
2024年第4期392-396,400,F0003,共7页
Jiangsu Medical Journal
基金
天津市北辰区科技计划项目(SHGY-2021021)。
关键词
三维斑点追踪成像技术
急性心肌梗死
经皮冠状动脉介入治疗
左心室整体纵向应变
Three-dimensional speckle tracking imaging
Acute myocardial infarction
Percutaneous coronary intervention
Left ventricular global longitudinal strain
