摘要
目的 探讨三维斑点追踪成像技术(3D-STI)对心肌梗死患者经皮冠状动脉介入治疗(PCI)后发生主要不良心血管事件(MACE)的预测效能。方法 回顾性选择2019年6月至2021年7月于浙江大学医学院附属金华医院接受PCI且随访至2022年8月的心肌梗死患者86例,根据随访结果是否发生MACE分为观察组与对照组,比较两组患者左心室整体纵向应变(GLS)、整体环向应变(GCS)、整体径向应变(GRS)、整体面积应变(GAS)、左心室射血分数(LVEF)。采用Pearson相关分析3D-STI参数与MACE的相关性。采用ROC曲线分析GLS、GCS、GRS、GAS、LVEF参数预测MACE发生的AUC值、灵敏度、特异度。结果 发生MACE(观察组)18例。观察组术前GLS、GCS、GRS、GAS绝对值低于对照组,差异均有统计学意义(均P<0.05)。心肌梗死患者PCI术后1、6、12个月的GLS、GCS、GRS、GAS、LVEF绝对值值逐渐增高,且均高于术前,差异均有统计学意义(均P<0.05)。Pearson相关分析显示,GLS、GCS、GRS、GAS、LVEF与MACE均呈负相关(均P<0.05)。ROC曲线分析显示,3D-STI联合参数预测MACE的预测效能高于单一指标预测,AUC值0.944,灵敏度0.889,特异度0.897。结论 心肌梗死患者PCI术前3D-STI检测有助于预测术后MACE。
Objective To investigate the predicting efficacy of three-dimensional speckle tracking imaging(3D-STI) for major adverse cardiac event(MACE) in myocardial infarction(MI) patients after percutaneous coronary intervention(PCI). Methods Eighty-six MI patients who underwent PCI in Affiliated Jinhua Hospital, Zhejiang University School of Medicine from June 2019 to July 2021 and were followed up until August 2022 were retrospectively selected.They were divided into observation group and control group based on follow-up results. The left ventricular global longitudinal peak strain(GLS), global circumferential peak strain(GCS), global radial peak strain(GRS), global area strain(GAS), left ventricular ejection fraction(LVEF) were compared between the two groups. Pearson method was used to analyze the correlation between 3D-STI parameters and MACE. ROC curve was used to analyze the AUC value,sensitivity and specificity of GLS, GCS, GRS, GAS and LVEF parameters in predicting MACE. Results MACE occurred in(observation group) 18 patients. GLS, GCS, GRS and GAS absolute value were significantly lower in observation group than in control group(all P <0.05). GLS, GCS, GRS, GAS and LVEF absolute value gradually increased at 1, 6 and 12 months after PCI and were all significantly higher than those before the operation(all P<0.05).Pearson correlation analysis showed that GLS, GCS, GRS, GAS and LVEF were all negatively correlated with MACE(all P<0.05). ROC curve analysis showed that the accuracy of predicting MACE using a combination of 3D-STI parameters was significantly higher than that of each parameter, with AUC value of 0.944, sensitivity of 0.889, and specificity of0.897, respectively. Conclusion Pre-PCI 3D-STI measurement is helpful for predicting post operation MACE in MI patients.
作者
孔敏刚
杨道玲
陈傅华
陈静婉
徐琛
周一波
KONG Mingang;YANG Daoling;CHEN Fuhua;CHEN Jingwan;XU Chen;ZHOU Yibo(Department of Medical Ultrasound,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China)
出处
《心电与循环》
2024年第4期362-366,共5页
Journal of Electrocardiology and Circulation
基金
浙江省医药卫生科技计划项目(2020KY1012)
金华市科学技术局重点科技计划项目(2022-3-083)。
关键词
三维斑点追踪成像技术
心肌梗死
经皮冠状动脉介入术
左心室功能
主要不良心血管事件
Three-dimensional speckle tracking imaging
Myocardial infarction
Percutaneous coronary intervention
Left ventricular function
Adverse cardiac event
